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Individual

CHARLES JAY FURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY7705
CA

Other

Enumeration date
08/09/2011
Last updated
08/09/2011
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