Individual
MR. SIDNEY BROUSSARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1008 W AVENUE M14 STE AD383, PALMDALE, CA 93551-1441
(661) 510-6524
Mailing address
3830 BELLEZA WAY, PALMDALE, CA 93551-5666
(661) 510-6524
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
04/29/2022
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