Brad T Mitsdarffer, CRNA
Nurse Anesthetist, Certified Registered in Los Angeles, California
1790148328- Practice location
- 1401 S Grand Ave, Los Angeles, CA 90015-3010
- Phone
- 213-748-2411
- Fax
- —
- Last updated
- June 23, 2025
Brad Thomas Mitsdarffer is a Nurse Anesthetist, Certified Registered based in Los Angeles, CA. Brad Thomas Mitsdarffer practices in Los Angeles, CA and has the professional credentials of CRNA. The NPI Number for Brad Thomas Mitsdarffer is 1790148328 and holds a License No. 114912-23 (NH). The current practice location address for Brad Thomas Mitsdarffer is 1401 S Grand Ave, Los Angeles, CA 90015-3010 and can be reached out via phone at 213-748-2411.
Provider Profile Details
- NPI Number
- 1790148328
- Provider Name
- Brad Thomas Mitsdarffer
- Credential
- CRNA
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1401 S Grand Ave, Los Angeles, CA 90015-3010
- Phone Number
- 213-748-2411
- Primary Taxonomy
- Nurse Anesthetist, Certified Registered · 367500000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 31, 2016
- Last Update Date
- June 23, 2025
- Certification Date
- June 23, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1401 S Grand Ave
Los Angeles, CA 90015-3010 - City
- Los Angeles
- State
- California
- Zip
- 90015-3010
- Phone Number
- 213-748-2411
Provider Business Mailing Address Details
- Address
- 1540 Fairfield CT
Lewisville, TX 75077-3722 - City
- Lewisville
- State
- TX
- Zip
- 75077-3722
- Phone Number
- 214-223-3750
License Information
- License Number (1)
- 114912-23
- License State (1)
- NH
- Taxonomy (1)
- Nurse Anesthetist, Certified Registered · 367500000X
- License Number (2)
- AP130007
- License State (2)
- TX
- Taxonomy (2)
- Nurse Anesthetist, Certified Registered · 367500000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Brad T Mitsdarffer, CRNA?
The NPI number of Brad T Mitsdarffer, CRNA is 1790148328. It was assigned on March 31, 2016 and is currently active in the NPPES registry.
What is the specialty of Brad T Mitsdarffer, CRNA?
Brad T Mitsdarffer, CRNA is registered under the primary taxonomy Nurse Anesthetist, Certified Registered (code 367500000X), licensed in NH under license number 114912-23.
Where does Brad T Mitsdarffer, CRNA practice?
The practice location is 1401 S Grand Ave, Los Angeles, CA 90015-3010. The office can be reached at 213-748-2411 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790148328 directly on the NPPES registry website.