Provider Demographics
NPI:1407804701
Name:BRAGUNIER, CHARLES E (MPT)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:E
Last Name:BRAGUNIER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S ANDREASEN DR
Mailing Address - Street 2:STE. C
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-1917
Mailing Address - Country:US
Mailing Address - Phone:760-591-7750
Mailing Address - Fax:760-294-9813
Practice Address - Street 1:9830 PROSPECT AVE
Practice Address - Street 2:STE. A
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4375
Practice Address - Country:US
Practice Address - Phone:619-448-4860
Practice Address - Fax:619-448-1639
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT22045EMedicare ID - Type Unspecified