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General NPI Number Information
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NPI Number | 1164904850
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Entity Type | Organization
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Legal Business Name | BRASWELL MEDICAL CONSULTANTS INC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 55425 SANTA FE TRL
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City | YUCCA VALLEY
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State | CA
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Zip | 92284-3117
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Country | US
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Telephone | 760-365-0887
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Fax | 760-365-4156
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Provider Business Mailing Address
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Address Line | 55425 SANTA FE TRL
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City | YUCCA VALLEY
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State | CA
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Zip | 92284-3117
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Country | US
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Telephone | 760-365-0887
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Fax | 760-365-4156
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JAMES HAROLD BRASWELL
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Credential |
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Telephone | 909-795-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 366404041
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License Number State | CA
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