Individual
SUSAN LOUISE CHARETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #365, LOS ANGELES, CA 90095-3075
(310) 206-8272
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 206-8272
(310) 206-3551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A65322
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A65322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A653220
—
CA
Enumeration date
07/11/2006
Last updated
02/08/2010
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