Provider Demographics
NPI:1912462508
Name:BRADLEY, TZVETA
Entity type:Individual
Prefix:
First Name:TZVETA
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TZVETA
Other - Middle Name:
Other - Last Name:MIHOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:656 SPRINGER DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4565
Mailing Address - Country:US
Mailing Address - Phone:412-951-9471
Mailing Address - Fax:
Practice Address - Street 1:656 SPRINGER DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4565
Practice Address - Country:US
Practice Address - Phone:412-951-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist