CHARLES BROADWATER

SAN DIEGO, CA
NPI1043908163
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163WP0809X Registered Nurse, Psych/Mental Health, Adult
(Licence: CA  651695)
Enumeration Date2023-04-26
Last Update Date2023-04-26
Business Address
CHARLES BROADWATER RN
3853 ROSECRANS ST
SAN DIEGO, CA 92110-3115
Phone number: 619-692-8232
Mailing Address
CHARLES BROADWATER RN
3853 ROSECRANS ST
SAN DIEGO, CA 92110-3115
Phone number: 619-692-8232