Provider Demographics
NPI:1730292194
Name:BRADEN PARTNERS LP
Entity Type:Organization
Organization Name:BRADEN PARTNERS LP
Other - Org Name:PACIFIC PULMONARY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-893-1518
Mailing Address - Street 1:4300 STINE RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-2354
Mailing Address - Country:US
Mailing Address - Phone:661-396-3720
Mailing Address - Fax:661-832-6010
Practice Address - Street 1:2501 W BEHREND DR
Practice Address - Street 2:SUITE 25/27
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4146
Practice Address - Country:US
Practice Address - Phone:623-580-0033
Practice Address - Fax:623-580-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ691817Medicaid
0393850051Medicare NSC