Provider Demographics
NPI:1851390264
Name:ARNSBERGER, BRADLEY KIRK (FNP-C/PA-C)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:KIRK
Last Name:ARNSBERGER
Suffix:
Gender:M
Credentials:FNP-C/PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 W. LACEY BVLD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5906
Mailing Address - Country:US
Mailing Address - Phone:559-583-4617
Mailing Address - Fax:559-583-4625
Practice Address - Street 1:41696 ROAD 128
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-2059
Practice Address - Country:US
Practice Address - Phone:559-528-6966
Practice Address - Fax:559-528-3665
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14631363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX65700Medicaid
S56849Medicare UPIN
CA1851390264Medicare PIN