Healthcare Provider Details

I. General information

NPI: 1801728001
Provider Name (Legal Business Name): BRADLEY MATSUBARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 CITRACADO PKWY
ESCONDIDO CA
92025-6412
US

IV. Provider business mailing address

521 CITRACADO PKWY
ESCONDIDO CA
92025-6412
US

V. Phone/Fax

Practice location:
  • Phone: 858-228-6865
  • Fax:
Mailing address:
  • Phone: 858-228-6865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License NumberA71772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: