Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bradley Jay E. Professional Corporation

Organization Specialist · NPI 1689415911

Bradley Jay E. Professional Corporation is a Specialist in Fullerton, California. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

2501 E Chapman Ave Unit 107-C
Fullerton, CA 92831-3132
Phone: (626) 429-0088
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1689415911
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jackson Tea — Manager · (626) 429-0088
Other names Revive Health; Revive Men'S Health
NPI enumeratedJune 3, 2024
Last updated in NPPESJune 3, 2024
Certification dateJune 3, 2024
Mailing address11278 Los Alamitos Blvd Unit 830, Los Alamitos, CA 90720-3958

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