Individual
DR. CHARLES ALAN JANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4000 TYLER ST, RIVERSIDE, CA 92503-3402
(951) 687-7100
(951) 687-1663
Mailing address
4000 TYLER ST, RIVERSIDE, CA 92503-3402
(951) 687-7100
(951) 687-1663
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0081580
—
CA
Enumeration date
08/19/2006
Last updated
07/08/2007
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