MEDICARE: BRADLEY ROBERT MEIER PHD

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
1	103T00000X	Psychologist	PSY22906	CA
2	103TC1900X	Counseling Psychologist	PSY22906	CA
3	103TA0400X	Addiction (Substance Use Disorder) Psychologist	PSY22906	CA
4	103TC0700X	Clinical Psychologist	PSY22906	CA
5	103TC2200X	Clinical Child & Adolescent Psychologist	PSY22906	CA
6	103TB0200X	Cognitive & Behavioral Psychologist	PSY22906	CA
7	103TF0200X	Forensic Psychologist	PSY22906	CA
8	103TP2701X	Group Psychotherapy Psychologist	PSY22906	CA
9	103TH0004X	Health Psychologist	PSY22906	CA
10	103TH0100X	Health Service Psychologist	PSY22906	CA

General Provider Information

NPI Number	:	1134142292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY ROBERT MEIER PHD

Provider Business Mailing Address
First Line	:	918 BRAEWOOD CT
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3754
Country	:	US
Telephone Number	:	610-324-3692
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W 5TH ST
Second Line	:	SUITE 310
City	:	LOS ANGELES
State	:	CA
Zip	:	90071-2004
Country	:	US
Telephone Number	:	610-324-3692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/11/2010

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