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CHARLES MELVIN BANKS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 943-2000
Mailing address
4030 E MORADA LN APT 2101, STOCKTON, CA 95212-1638
(706) 536-7727

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95327889
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002204
CA

Other

Enumeration date
09/05/2023
Last updated
10/04/2023
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