MEDICARE: DR. BRADFORD DEAN CASE D.C., N.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
1	175F00000X	Naturopath	ND1081	CA
2	111N00000X	Chiropractor	0232200	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0232200	OTHER	CA	MEDICARE

General Provider Information

NPI Number	:	1386831055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADFORD DEAN CASE D.C., N.D.

Provider Business Mailing Address
First Line	:	2930 FIRST AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103
Country	:	US
Telephone Number	:	831-915-6783
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 SORRENTO VALLEY BLVD.
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121
Country	:	US
Telephone Number	:	831-663-2284
Fax Number	:	831-663-2288

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

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	02/09/2024

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