Individual
CHARLES GREGORY MADDUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11332 MOUNTAIN VIEW AVE STE C, LOMA LINDA, CA 92354
(909) 558-6131
(909) 558-0430
Mailing address
2100 LITTLE MOUNTAIN LN, MOUNT VERNON, WA 98274-8752
(360) 416-6735
(360) 424-6954
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD61051076
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2016
Last updated
07/21/2022
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