Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1215568852 |
---|---|
Provider Name | Mr. Charles Fred Morgan III |
First Address | San Diego, CA 92108-6561 |
Second Address | San Diego, CA 92108-6561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2020 |
Last Update Date | 02/02/2020 |