Individual
CHARLES MCCLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4535 LA CRESCENTA AVE, LA CRESCENTA, CA 91214-2912
(818) 388-6372
Mailing address
4535 LA CRESCENTA AVE, LA CRESCENTA, CA 91214-2912
(818) 388-6372
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
101762
OK
Other
Enumeration date
03/12/2012
Last updated
03/12/2012
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