Provider Demographics
NPI:1801135389
Name:JOSEPH, BRADLEY K (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:K
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1407
Mailing Address - Country:US
Mailing Address - Phone:805-729-5252
Mailing Address - Fax:
Practice Address - Street 1:926 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1407
Practice Address - Country:US
Practice Address - Phone:805-729-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG32149OtherINTERNAL MEDICINE
CAG32149OtherBNDD# AJ 9141045