Healthcare Provider Details

I. General information

NPI: 1740209014
Provider Name (Legal Business Name): BRADLEY ROY NOON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SPECTRUM CENTER DR STE 400
IRVINE CA
92618-4989
US

IV. Provider business mailing address

300 SPECTRUM CENTER DR STE 400
IRVINE CA
92618-4989
US

V. Phone/Fax

Practice location:
  • Phone: 949-216-0491
  • Fax: 949-606-9933
Mailing address:
  • Phone: 949-216-0491
  • Fax: 949-606-9933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA78661
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberH62948
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberA78661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: