Healthcare Provider Details
I. General information
NPI: 1083740765
Provider Name (Legal Business Name): BRADLEY JASON MONASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/26/2007
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UCSF MEDICAL CENTER 450 STANYAN STREET
SAN FRANCISCO CA
94117
US
IV. Provider business mailing address
UCSF MEDICAL CENTER 450 STANYAN STREET
SAN FRANCISCO CA
94117
US
V. Phone/Fax
- Phone: 415-476-5928
- Fax:
- Phone: 415-476-5928
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 236345 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 236345 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: