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General NPI Number Information
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NPI Number | 1245541861
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Entity Type | Individual
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Provider Name | BRAD CHARLES ANDERSON OTR/L
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Gender | Male
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 1296 N CHESTER AVE
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City | PASADENA
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State | CA
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Zip | 91104-2947
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Country | US
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Telephone | 626-676-6558
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Fax | 626-389-8748
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Provider Business Mailing Address
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Address Line | 1443 E WASHINGTON BLVD NO. 806
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City | PASADENA
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State | CA
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Zip | 91104-2650
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Country | US
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Telephone | 626-676-6558
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Fax | 626-389-8748
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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 | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225XE1200X
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Taxonomy Name | Ergonomics Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 4438
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License Number State | CA
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