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Contact Information

EDWIN C BROADNAX
3801 UNIVERSITY AVENUE, SUITE 400
RIVERSIDE, CA92501
 Phone: 951-955-7108
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

1041S0200X
Indicates primary specialty

NPI Profile & details for EDWIN C BROADNAX · (Male)

NPI Number 1518248640
Status Active
Credentials
Entity Individual
Enumeration date 09/02/2011
Last updated 09/02/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 104100000X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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