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1043908163
CHARLES BROADWATER
SAN DIEGO, CA
NPI
1043908163
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0809X Registered Nurse Psychiatric/Mental Health, Adult
(Licence: CA 651695)
Enumeration Date
2023-04-26
Last Update Date
2023-04-26
Business Address
CHARLES BROADWATER RN
3853 ROSECRANS ST
SAN DIEGO, CA 92110-3115
Phone number: 619-692-8232
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Mailing Address
CHARLES BROADWATER RN
3853 ROSECRANS ST
SAN DIEGO, CA 92110-3115
Phone number: 619-692-8232
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