Individual
CHARLES MENO DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
704 CANYON CREST DR, SIERRA MADRE, CA 91024-1312
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A157451
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A157451
CA
Other
Enumeration date
06/22/2017
Last updated
04/04/2024
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