NPI 1003325499

Bradly James Stilley, IDC

Practitioner Independent Duty Corpsman San Diego, CA

Practice location

Address: 34800 Bob Wilson Dr, San Diego, CA 92134-1098
Phone: (360) 941-9989
Mailing address: 10156 Orleck St, San Diego, CA 92124-2509

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1003325499
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Sep 2017
Record last updated: 28 Sep 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.