Organization
CHARLES L WISEMAN MD APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L WISEMAN MD (OWNER/PRESIDENT)
(213) 483-8464
Entity
Organization
Contact information
Practice address
201 S ALVARADO ST, SUITE 321, LOS ANGELES, CA 90057-2320
(213) 483-8464
(213) 483-8307
Mailing address
201 S ALVARADO ST, SUITE 321, LOS ANGELES, CA 90057-2320
(213) 483-8464
(213) 483-8307
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
A24132
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A241320
—
CA
Enumeration date
09/27/2007
Last updated
09/27/2007
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