Individual
AMELIA LILLIAN BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 UNIVERSITY AVE, SAN DIEGO, CA 92105-1418
(858) 609-9073
Mailing address
PO BOX 1933, LEMON GROVE, CA 91946-1933
(858) 609-9073
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/01/2011
Last updated
03/15/2025
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