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General NPI Number Information
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NPI Number | 1982789517
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Entity Type | Individual
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Provider Name | KATHLEEN ELIZABETH BRADLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 32129 LINDERO CYN RD #106
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 818-609-0427
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Fax | 818-609-0475
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Provider Business Mailing Address
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Address Line | 18411 CLARK STREET #300
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 818-609-0427
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Fax | 818-609-0475
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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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | A50764
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License Number State | CA
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