BRADLEY JAY E. PROFESSIONAL CORPORATION
NPI 1689415911
Specialist in Fullerton, CA

Q: What is Bradley Jay E. Professional Corporation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since June 03, 2024

2501 E CHAPMAN AVE UNIT 107-C, FULLERTON, CA 92831(626) 429-0088 Get Directions Write a Review

NPPES record last updated: June 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Bradley Jay E. Professional Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY JAY E. PROFESSIONAL CORPORATION (NPI 1689415911), doing business as Revive Health, is a healthcare organization registered as a specialist in Fullerton, California and active in the NPI registry since June 2024. The organization lists Jackson Tea, Manager, as its authorized official.

NPPES Registry Identity

NPI1689415911

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameBRADLEY JAY E. PROFESSIONAL CORPORATION

Location Address2501 E CHAPMAN AVE UNIT 107-CFullerton, CA 92831-3132

Mailing Address11278 Los Alamitos Blvd Unit 830Los Alamitos, CA 90720-3958

Phone(626) 429-0088

Organization SubpartNo

Authorized OfficialJackson TeaManager · (626) 429-0088

Enumeration DateJune 3, 2024

NPPES CertifiedJune 3, 2024

✔ NPI 1689415911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2501 E CHAPMAN AVE UNIT 107-C, Fullerton, CA 92831

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Other Names 2

Doing Business AsRevive Health

Doing Business AsRevive Men's Health

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VALERIE CACHO MEDICAL CORP

Internal Medicine (Sleep Medicine)

2501 E CHAPMAN AVE UNIT 107-C
FULLERTON, CA 92831

Orange County (657) 553-3799

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Jay E. Professional Corporation's NPI number?

The NPI number for Bradley Jay E. Professional Corporation is 1689415911. It was assigned to this organization in the NPPES registry on June 3, 2024. The provider is doing business as Revive Health and Revive Men's Health.

Where is Bradley Jay E. Professional Corporation located?

Bradley Jay E. Professional Corporation is located at 2501 E Chapman Ave Unit 107-C, Fullerton, CA 92831. The listed phone number is (626) 429-0088.

What is Bradley Jay E. Professional Corporation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Bradley Jay E. Professional Corporation was last updated on June 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.