Individual
CHARLES EDMUND FTACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CNS
Contact information
Practice address
4078 HAMILTON ST APT 3, SAN DIEGO, CA 92104-6144
(615) 815-6183
Mailing address
4078 HAMILTON ST APT 3, SAN DIEGO, CA 92104-6144
(615) 815-6183
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
10/18/2022
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