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Individual

ANDREW C CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 MEDICAL PLAZA, #B200, LOS ANGELES, CA 90095
(310) 794-1195
(310) 794-7491
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G61024
CA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
G61024
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G610240
CA
Enumeration date
07/13/2006
Last updated
01/15/2020
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