Individual
DR. CHARLES E NIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
960 E GREEN ST, SUITE L11, PASADENA, CA 91106-2412
(626) 599-7600
(626) 599-7601
Mailing address
960 E GREEN ST, SUITE L11, PASADENA, CA 91106-2412
(626) 599-7600
(626) 599-7601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A54329
CA
Other
Enumeration date
06/29/2006
Last updated
10/31/2016
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