Individual
CHARLES CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 15TH ST STE 102, SANTA MONICA, CA 90404-1810
(310) 825-5358
(310) 825-0884
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G68255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G682550
—
CA
Enumeration date
08/23/2006
Last updated
12/23/2019
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