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Individual

CHARLES ROYAL REPPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA13860

Contact information

Practice address
27200 CALAROGA AVE, ST. ROSE HOSPITAL, HAYWARD, CA 94545-4339
(510) 264-4000
Mailing address
2410 RUSSELL ST, APT. #C, BERKELEY, CA 94705-2077
(510) 843-1235

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
PA13860
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA13860
PHYSICIAN ASSISTANT
CA
Enumeration date
01/29/2007
Last updated
07/08/2007
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