Individual
STEVEN TIGHE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6851 RICO CT, SAN DIEGO, CA 92111-7029
(626) 319-1361
Mailing address
6851 RICO CT, SAN DIEGO, CA 92111-7029
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
616-19-0984
—
CA
Enumeration date
04/23/2019
Last updated
04/23/2019
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