Bradley A Jackson
Medical Specialty
Professional ID
- NPI: 1124206487
- PECOS ID: 1658527544
- Enrollment ID: I20120808000709
- Credential(MD, DO, DPM):
- Medical School: University Of Southern California School Of Medicine
- Medical School Graduation Year: 2006
Hospital Service
- Hospital CCN1: 050168
- Business Name (LBN)1: St Jude Medical Center
Medical Practices
- Organization Name: St Jude Radiology Medical Group Inc
- Group Practice ID assigned by PECOS: 7214838002
- Number of Group Practice member: 17
Location
- Address1: 101 E Valencia Mesa Dr
- Address2:
- City: Fullerton
- State: California
- Zip Code: 92835
- Phone Number: (714)992-3978
Location
- Address1: 2151 N Harbor Blvd
- Address2:
- City: Fullerton
- State: California
- Zip Code: 92835
- Phone Number: (714)992-3000
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):