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NPI Code Detail

MEDICARE: MARIA ELIZABETH BELOY BRADLEY PA-C

MEDICARE: MARIA ELIZABETH BELOY BRADLEY PA-C
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
1363A00000XPhysician AssistantPA60030912WA
2363A00000XPhysician Assistant354518-1206UT
3363A00000XPhysician Assistant354518-8906UT
4363A00000XPhysician AssistantPA17041CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117041OTHERCAPAC-CALIFORNIA PA LICENSE

General Provider Information

NPI Number : 1578584223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ELIZABETH BELOY BRADLEY PA-C
Provider Business Mailing Address
First Line : 600 HOSKING AVE APT 37D
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-5731
Country : US
Telephone Number : 509-594-1135
Fax Number :
Provider Business Practice Location Address
First Line : 857 W CHILDS AVE
Second Line :
City : MERCED
State : CA
Zip : 95341-6862
Country : US
Telephone Number : 209-384-6487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/09/2024

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Directions to “ MARIA ELIZABETH BELOY BRADLEY PA-C” Practice Location

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