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

Mr. Bradley Wayne Proctor, IDC

Individual provider Independent Duty Corpsman · NPI 1629635032

Mr. Bradley Wayne Proctor, IDC is an Independent Duty Corpsman in San Diego, California. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

34101 Farenholt Ave
San Diego, CA 92134-7000
Phone: (619) 532-7968
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1629635032
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedMay 21, 2019
Last updated in NPPESMarch 11, 2025
Certification dateMarch 11, 2025

Other providers in San Diego