Individual
CHERYL HAYTOCK BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6825
Mailing address
707 ORANGE AVE UNIT 1B, CORONADO, CA 92118-2240
(910) 375-1240
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH017565
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202209665
PHARMACY LICENSE
VA
01
—
PS34070
PHARMACY LICENSE
FL
01
—
RPH017565
PHARMACIST LICENSE
GA
Enumeration date
02/14/2006
Last updated
07/23/2013
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