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

Brady Supriadi, DPT

Individual provider Physical Therapist · NPI 1346905841

Brady Supriadi, DPT is a Physical Therapist in Private Practice in Fontana, California. Qualified in 2019, 7 years ago. Practices with California Luna Care Physical Therapy PC, a 773-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2021
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

8545 Sierra Ave
Fontana, CA 92335-3868
Phone: (909) 365-3557
Fax: (909) 658-8987
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT301113 (CA)

Record details

NPI number1346905841
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 1, 2021
Last updated in NPPESNovember 1, 2021
Certification dateNovember 1, 2021
Mailing address8545 Sierra Ave, Fontana, CA 92335-3868

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice California Luna Care Physical Therapy Pc — 773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fontana