Individual
DR. CHARLES H. HALSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 J ST, SUITE 300, SACRAMENTO, CA 95816-4300
(916) 734-2890
Mailing address
451 HEALTH SCIENCES DR., 5303 GBSF, DAVIS, CA 95616
(530) 752-6778
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207REO10X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00392
PI NUMBER
CA
01
—
G026076
STATE LICENSE
CA
Enumeration date
10/16/2006
Last updated
03/07/2023
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