Provider Demographics
NPI:1740206945
Name:MCAFEE, BRADLEY C (MS)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:C
Last Name:MCAFEE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 LOMITA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-1905
Mailing Address - Country:US
Mailing Address - Phone:310-378-7070
Mailing Address - Fax:310-375-6006
Practice Address - Street 1:3655 LOMITA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-1905
Practice Address - Country:US
Practice Address - Phone:310-378-7070
Practice Address - Fax:310-375-6006
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2194237600000X, 237700000X, 231H00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0023310Medicaid
CA1740206945Medicaid
CAHA0023310Medicaid