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BRADLEY CHARLES BANDERA MD NPI 1427205681


NPI Information

NPI: 1427205681
Provider Name: BRADLEY CHARLES BANDERA, MD
Classification: Surgery - 2086X0206X
Entity Type: Individual

Specialization: Surgical Oncology

Organization: AUGUSTA SURGICAL GROUP, P.C.

PECOS Registration: Yes

Address:
2200 SANTA MONICA BLVD
JOHN WAYNE CANCER INSTITUTE
SANTA MONICA, CA
ZIP 90404
Phone: (310) 449-5249
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Bradley Charles Bandera, MD is a surgical oncology surgery in Santa Monica, CA with 17 years of experience. The provider is a surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. Bradley Charles Bandera, MD NPI is 1427205681. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

2200 SANTA MONICA BLVD
JOHN WAYNE CANCER INSTITUTE
SANTA MONICA, CA
ZIP 90404
Phone: (310) 449-5249

The NPI 1427205681 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/19/2008 and was last updated on 11/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training Program61600GEORGIANo
22086X0206XSurgerySurgical OncologyA135798CALIFORNIAYes
3208600000XSurgery61600GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200619660AMEDICAIDOKLAHOMA
2201124040AMEDICAIDKANSAS
31427205681MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.