Marc A Charles Md Inc | |
1501 N Harbor Blvd Ste 203 Fullerton CA 92835-3803 | |
(714) 871-5411 | |
(714) 871-2401 |
Full Name | Marc A Charles Md Inc |
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Speciality | Psychiatry & Neurology |
Location | 1501 N Harbor Blvd Ste 203, Fullerton, California |
Authorized Official Name and Position | Marc A Charles (OWNER) |
Authorized Official Contact | 7148715411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Marc A Charles Md Inc 1501 N Harbor Blvd Ste 203 Fullerton CA 92835-3803 Ph: (714) 871-5411 | Marc A Charles Md Inc 1501 N Harbor Blvd Ste 203 Fullerton CA 92835-3803 Ph: (714) 871-5411 |
NPI Number | 1457544207 |
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Provider Enumeration Date | 08/24/2007 |
Last Update Date | 02/10/2011 |
Medicare PECOS PAC ID | 8123017316 |
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Medicare Enrollment ID | O20040511001814 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457544207 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | G40535 (California) | Primary |
Provider Name | Marc A Charles |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1316032386 PECOS PAC ID: 1850380049 Enrollment ID: I20040513001101 |
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