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General NPI Number Information
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NPI Number | 1194783530
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Entity Type | Individual
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Provider Name | BRADLEY S WALKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 200 MERCY CIRCLE BDLG H-200 SOUTH SIDE 4TH FLOOR
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City | OCEANSIDE
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-725-1288
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Fax |
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Provider Business Mailing Address
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Address Line | 383 N 1340 E
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City | PROVO
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State | UT
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Zip | 84606-5169
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Country | US
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Telephone | 702-528-4297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | G73117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 7042
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G73117
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | G73117
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License Number State | CA
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