Charles Chandler, md
Surgery in Santa Monica, CA. Individual provider (NPI-1).
NPI number1295842771
StatusActive
Last updated in NPPESDec 23, 2019
Details
- NPI
- 1295842771
- Entity type
- Individual (NPI-1)
- Name
- Charles Chandler
- Credential
- md
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2006
- Certification date
- Dec 23, 2019
- Last updated
- Dec 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | G68255 | CA | Yes |
Practice location
1304 15th St Ste 102Santa Monica, CA 90404-1810
Phone 310-825-5358 · Fax 310-825-0884
Mailing address
5767 W Century BlvdSuite 400
Los Angeles, CA 90045-5631
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