Healthcare Provider Details

I. General information

NPI: 1427473818
Provider Name (Legal Business Name): BRAD PICHE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 03/18/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

IV. Provider business mailing address

181 W MADISON ST SUITE 3825
CHICAGO IL
60602-4510
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone: 312-219-2230
  • Fax: 312-219-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51469
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA6030
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085005766
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: