Provider Demographics
NPI:1598737587
Name:HALE, BRADEN RANDALL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BRADEN
Middle Name:RANDALL
Last Name:HALE
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-6460
Mailing Address - Fax:619-532-6299
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO # 105550
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-1098
Practice Address - Country:US
Practice Address - Phone:505-272-5666
Practice Address - Fax:505-272-4435
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG79430207RI0200X
NMMD2020-0838207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease