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NPI Code Detail

MEDICARE: DR. ALEXANDER TYSON BRADLEY MD

MEDICARE: DR. ALEXANDER TYSON BRADLEY MD
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
1207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianA188164CA

General Provider Information

NPI Number : 1194259077
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDER TYSON BRADLEY MD
Provider Business Mailing Address
First Line : PO BOX 31396
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-8396
Country : US
Telephone Number : 925-939-8585
Fax Number :
Provider Business Practice Location Address
First Line : 4000 DUBLIN BLVD STE 100
Second Line :
City : DUBLIN
State : CA
Zip : 94568-3122
Country : US
Telephone Number : 925-939-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2017
Last Update Date : 11/07/2025

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