Individual provider · NPI-1

Dr. Adam Bray, DO

Family Medicine · Pomona, CA

NPI number1679131007
StatusActive
Last updated in NPPESJan 10, 2025

Details

NPI
1679131007
Entity type
Individual (NPI-1)
Name
Dr. Adam Bray
Credential
DO
Sex
Male
Sole proprietor
Yes
Enumeration date
May 31, 2019
Certification date
Jan 10, 2025
Last updated
Jan 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine20A20199CAYes
390200000X Student in an Organized Health Care Education/Training Program20A20199CA

Practice location

1770 N Orange Grove Ave Ste 101
Pomona, CA 91767-3027

Phone 909-469-9494 · Fax 909-469-2120

Mailing address

617 Avenue F
Bogalusa, LA 70427-3637

Phone 985-730-6970

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