Bradley Trent Clair
Interventional Cardiology Internist - Cardiovascular Disease
5196 Hill Rd E Ste 202
Lakeport
, California 95453-6360
Bradley Trent Clair
Interventional Cardiology Internist - Cardiovascular Disease
5196 Hill Rd E Ste 202
Lakeport
, California 95453-6360
(707) 263-8137
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Bradley Trent Clair
- 3536 Mendocino Ave Ste 200
- Santa Rosa, CA
- Zip : 95403-3634
- Fax : (707) 263-8137
- Phone : (707) 575-6049
Second Address
- Bradley Trent Clair
- 5196 Hill Rd E Ste 202
- Lakeport, CA
- Zip : 95453-6360
- Fax : (707) 263-8137
- Phone : (707) 263-1777
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | A45681 | CA |
| N | 207RI0011X | Interventional Cardiology | A45681 | CA |
National Provider Identifier
| NPI | 1083611198 |
|---|---|
| Provider Name | Bradley Trent Clair |
| First Address | Santa Rosa, CA 95403-3634 |
| Second Address | Lakeport, CA 95453-6360 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/07/2005 |
| Last Update Date | 07/02/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00A456810 | (05) | CA |
| 00A456810 | BLUE SHIELD OF CALIFORNIA (01) | CA |
| 060020642 | RAILROAD MEDICARE (01) | CA |
| F59210 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.