Individual
CHARLES LYNN HARDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 13TH ST, RAMONA, CA 92065-2711
(760) 789-5160
(760) 789-6316
Mailing address
120 CRAVEN RD STE 201, SAN MARCOS, CA 92078-4237
(760) 291-6650
(858) 618-1523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G70382
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G70382
MEDICAL LICENSE
CA
Enumeration date
08/26/2010
Last updated
02/16/2024
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