MEDICARE: DAVID C BRADSHAW MD PC

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	208100000X	Physical Medicine & Rehabilitation Physician	C385990	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811990468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C BRADSHAW MD PC

Provider Business Mailing Address
First Line	:	2250 HAYES ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-1013
Country	:	US
Telephone Number	:	415-750-5761
Fax Number	:	415-666-0210

Provider Business Practice Location Address
First Line	:	19830 LAKE CHABOT RD
Second Line	:	STE C
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4063
Country	:	US
Telephone Number	:	510-537-7873
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/27/2008

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Directions to “ DAVID C BRADSHAW MD PC” Practice Location

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