Provider Demographics
NPI:1346235942
Name:WILLIAMS, BRADLEY ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ROBERT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25101 DORIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1717
Mailing Address - Country:US
Mailing Address - Phone:310-325-1017
Mailing Address - Fax:310-325-1017
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:PAVILION IV
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
CARPH313181835P1200X
VA09721835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric