OrganizationActive
Bradley Jay E. Professional Corporation
NPI 1689415911 · Specialist · Fullerton, CA
Bradley Jay E. Professional Corporation is a Specialist organization in Fullerton, CA (NPI 1689415911).
Provider details
- NPI number
- 1689415911
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Jackson Tea, Manager(626) 429-0088
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2501 E Chapman Ave Unit 107-C
Fullerton, CA 92831-3132
Phone: (626) 429-0088
Street-level locationGet directions
Mailing address
11278 Los Alamitos Blvd Unit 830
Los Alamitos, CA 90720-3958
Other names (DBA / former)
- Doing business as
- Revive Health
- Doing business as
- Revive Men'S Health
Registry dates
- Enumerated
- 2024-06-03
- Last updated
- 2024-06-03
- Certified
- 2024-06-03
Frequently asked questions
- What is Bradley Jay E. Professional Corporation's NPI number?
- Bradley Jay E. Professional Corporation's National Provider Identifier (NPI) is 1689415911, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bradley Jay E. Professional Corporation?
- Bradley Jay E. Professional Corporation is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Bradley Jay E. Professional Corporation located?
- Bradley Jay E. Professional Corporation's practice location on file with NPPES is 2501 E Chapman Ave Unit 107-C, Fullerton, CA 92831-3132.
- What is Bradley Jay E. Professional Corporation's phone number?
- The practice phone number listed in the NPPES registry for Bradley Jay E. Professional Corporation is (626) 429-0088.
- Who is the authorized official for Bradley Jay E. Professional Corporation?
- The authorized official listed on Bradley Jay E. Professional Corporation's NPPES record is Jackson Tea, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bradley Jay E. Professional Corporation's NPI active?
- Yes — Bradley Jay E. Professional Corporation's NPI (1689415911) is active in the NPPES registry as of the last update on 2024-06-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.