Individual
CHARLES T CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2120 COWELL BLVD, STE. 142, DAVIS, CA 95618-7835
(818) 817-9832
Mailing address
13700 MARINA POINTE DR, UNIT 1606, MARINA DEL REY, CA 90292-9271
(310) 710-2489
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
101796-875
WI
207L00000X
Anesthesiology Physician
Primary
G072321
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497962914
—
WI
Enumeration date
05/16/2007
Last updated
05/29/2024
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