Individual
CHARLES C. MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369
(909) 425-7679
(909) 425-6635
Mailing address
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369
(909) 425-7679
(909) 425-6635
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A86135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A861350
—
CA
Enumeration date
01/08/2007
Last updated
08/08/2013
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