Individual
CHARLES MARK CARLSTROEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 XIMENO AVE, #230, LONG BEACH, CA 90804-2150
(562) 494-3633
Mailing address
1650 XIMENO AVE, #230, LONG BEACH, CA 90804-2150
(562) 494-3633
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G45430
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR000082
—
CA
Enumeration date
11/02/2006
Last updated
07/08/2007
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