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NPI Code Detail

MEDICARE: MR. BRADFORD STEPHEN DEAN PHARM D.

MEDICARE: MR. BRADFORD STEPHEN DEAN PHARM D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist38563CA

General Provider Information

NPI Number : 1053611129
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRADFORD STEPHEN DEAN PHARM D.
Provider Business Mailing Address
First Line : 1850 PRAIRIE CITY RD
Second Line :
City : FOLSOM
State : CA
Zip : 95630-9518
Country : US
Telephone Number : 916-608-2455
Fax Number :
Provider Business Practice Location Address
First Line : 1850 PRAIRIE CITY RD
Second Line :
City : FOLSOM
State : CA
Zip : 95630-9518
Country : US
Telephone Number : 916-608-2455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2010
Last Update Date : 10/23/2010

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