MR. RONALD L BRADSHAW (NPI# 1588705172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588705172 |
| Entity Type | Individual |
| Full Name | MR. RONALD L BRADSHAW |
| Credential | P.A. |
| Practice Address |
3467 Whittier Blvd First Floor Los Angeles CA 90023-1707 |
| Mailing Address |
12535 Oxnard St # 103 North Hollywood CA 91606-4450 |
| Practice Telephone | 3232681785 |
| Practice Fax Number | 3232681786 |
| Mailing Telephone | 8182169163 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-05-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA14359 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PPIN | WPA14359A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912962267 | Ronald W Bradshaw | Family Medicine | 209 Speight Ave, Waco, TX 76706-1507 | 2006-04-19 |
| Street Address |
3467 WHITTIER BLVD FIRST FLOOR |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90023-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750428264 | Glenmountain Medical Group Inc | Family Medicine | 3467 Whittier Blvd, First Floor, Los Angeles, CA 90023-1707 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1275059511 | Jeff Moreno | Psychoanalyst | 550 Vermount Ave, Los Angeles, CA 90023 | 2017-08-18 |
| 1457714297 | Isabel Garcia | Counselor | 4543 Sabina Street, Los Angeles, CA 90023 | 2016-03-30 |
| 1275950115 | Daniel Lemor | Ophthalmology | 4036 Whittier Blvd Ste 202, Los Angeles, CA 90023 | 2014-03-27 |
| 1073951992 | Behavioral Health Services, Inc. | Community/Behavioral Health | 2515 Whittier Blvd., Los Angeles, CA 90023 | 2013-06-13 |
| 1003115312 | H.r.imankhan,dds,inc | Dentist | 3356 E. Olympic Blvd, Los Angeles, CA 90023 | 2011-03-25 |
| 1508006297 | Ricca Tinnin | Physician Assistant | 1200 N State St., Dept E.r., La, CA 90023 | 2009-02-20 |
| 1538366851 | Sun Heung Lui | Counselor | 3421 E. Olympic Blvd., Los Angeles, CA 90023 | 2007-06-29 |
| 1851519623 | Atlantic Recovery Services | Community/Behavioral Health | 3225 Flunter St, Estrada Courts Sea, Los Angeles, CA 90023 | 2007-04-24 |
| 1548486947 | Manasseh C Nwaigwe | General Practice | 1159 S. Lorena St, Los Angeles, CA 90023 | 2007-04-17 |
| Find all providers in zip 90023 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| 1942738943 | Sophavy Suon | Physician Assistant | 11611 San Vicente Blvd Lbby Level, Los Angeles, CA 90049-5106 | 2017-06-02 |
| 1619429503 | Rachel Frankenthal | Physician Assistant | 200 Medical Plz Ste 220, Ucla Department of Obgyn, Los Angeles, CA 90095-0001 | 2016-10-26 |
| 1982152815 | Accessmed A Physician Assistant Professional Corporation | Physician Assistant | 1055 W 7th St Fl 33, Los Angeles, CA 90017-2577 | 2016-09-20 |
| 1043766363 | Amber Joy Rangel | Physician Assistant | 2523 Armacost Ave, Los Angeles, CA 90064-2715 | 2016-08-28 |
| 1184080459 | Doreen Yasharel | Physician Assistant | 824 S Wooster St Apt 306, Los Angeles, CA 90035-1745 | 2016-01-02 |
| 1649649443 | Thuy Vo | Physician Assistant | 5841 Bowcroft St, Unit 2, Los Angeles, CA 90016-4955 | 2015-09-22 |
| 1649655663 | Carlee Ettinger | Physician Assistant | 2751 Rinconia Dr, Los Angeles, CA 90068-2227 | 2015-07-21 |
| 1841681467 | Lauren Layson | Physician Assistant | 4049 Via Marisol, Los Angeles, CA 90042-5055 | 2015-02-18 |
| 1871981282 | Dianne Desiree Rivera Navoa | Physician Assistant | 8631 W 3rd St Ste 1035e, Los Angeles, CA 90048-5964 | 2015-01-07 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90023 |
Please comment or provide details below to improve the information on MR. RONALD L BRADSHAW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.