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Individual

CASEY LEONARD CHARLTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1680 E 120TH ST, LOS ANGELES, CA 90059-3026
(424) 338-8000
Mailing address
5504 S GARTH AVE, LOS ANGELES, CA 90056-1309
(310) 702-1883

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R78026
AZ
208D00000X
General Practice Physician
1588285910
AZ

Other

Enumeration date
04/27/2020
Last updated
11/14/2024
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