Individual
KENNETH GARY CHARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1553 GRAND AVE, SUITE B, SAN MARCOS, CA 92078-2427
(760) 744-6226
(760) 744-6277
Mailing address
2982 CARRILLO WAY, CARLSBAD, CA 92009-3027
(760) 744-6226
(760) 744-6277
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E15360
CA
Other
Enumeration date
10/02/2006
Last updated
01/06/2014
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