Individual
MRS. MARIE PASCALE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
5850 S MAIN ST, LOS ANGELES, CA 90003-1215
(323) 897-6105
Mailing address
5850 S MAIN ST, LOS ANGELES, CA 90003-1215
(323) 897-6105
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
570234
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
CA
05
—
MEDICAID
—
CA
Enumeration date
01/26/2023
Last updated
01/26/2023
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