Individual
BRENDA BANTADOS WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 EUCLID AVE, NATIONAL CITY, CA 91950-3856
(619) 515-2399
Mailing address
1240 BROADWAY, EL CAJON, CA 92021-4994
(619) 515-2300
(619) 269-0674
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
272664
NY
207R00000X
Internal Medicine Physician
Primary
A119649
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2010
Last updated
06/01/2020
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