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Individual

ELLEN FRANCES CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
300 UCLA MEDICAL PLZ STE 2200, LOS ANGELES, CA 90095-8346
(310) 202-6204
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A166721
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F8040749
DRIVER'S LICENSE
CA
Enumeration date
04/04/2018
Last updated
07/08/2024
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