Individual
CHARLES FANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12607 INDIANAPOLIS ST, LOS ANGELES, CA 90066-1513
(626) 242-8778
Mailing address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(626) 242-8778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
57852
CA
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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