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General NPI Number Information
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NPI Number | 1972416147
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Entity Type | Organization
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Legal Business Name | BRADLEY & VAN DER LIST CONTINUUM, LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 755 E YOSEMITE AVE STE K
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City | MERCED
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State | CA
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Zip | 95340-8040
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Country | US
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Telephone | 209-261-6006
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Fax |
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Provider Business Mailing Address
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Address Line | 755 E YOSEMITE AVE STE K
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City | MERCED
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State | CA
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Zip | 95340-8040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICIAN
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Name | MICHAEL BRADLEY
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Credential | CPO
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Telephone | 916-833-3952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | NULL
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