Provider Demographics
NPI:1265804132
Name:NAJAC, BRADLEY
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:NAJAC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16211 DOWNEY AVE UNIT 113
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5588
Mailing Address - Country:US
Mailing Address - Phone:484-364-0597
Mailing Address - Fax:
Practice Address - Street 1:11190 WARNER AVE STE 300
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4045
Practice Address - Country:US
Practice Address - Phone:714-241-7000
Practice Address - Fax:714-241-7003
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant