Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic | 13397 | CA |
NPI | 1104936541 |
---|---|
Provider Name | Dr. Bradford Francis Martin |
First Address | Saratoga, CA 95070-4158 |
Second Address | Saratoga, CA 95070-4158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13397 | CA PT LICENSE NUMBAR (01) | CA |