Healthcare Provider Details

I. General information

NPI: 1972416147
Provider Name (Legal Business Name): BRADLEY & VAN DER LIST CONTINUUM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E YOSEMITE AVE STE K
MERCED CA
95340-8040
US

IV. Provider business mailing address

755 E YOSEMITE AVE STE K
MERCED CA
95340-8040
US

V. Phone/Fax

Practice location:
  • Phone: 209-261-6006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL BRADLEY
Title or Position: OWNER/ CLINICIAN
Credential: CPO
Phone: 916-833-3952