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General NPI Number Information
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NPI Number | 1568471845
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Entity Type | Organization
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Legal Business Name | BRADLEY I. SPIEGEL, M.D., INC.
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 415 ROLLING OAKS DRIVE SUITE#115
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1030
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Country | US
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Telephone | 805-370-4782
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Fax | 805-230-1107
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Provider Business Mailing Address
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Address Line | 415 ROLLING OAKS DRIVE SUITE#115
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1030
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Country | US
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Telephone | 805-370-4782
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Fax | 805-230-1107
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRADLEY I. SPIEGEL
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Credential | M.D.
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Telephone | 805-370-4782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G62100
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License Number State | CA
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