Charles Emmet Stout Jr., MD, PhD
Radiology, Vascular & Interventional Radiology in Riverside, CA. Individual provider (NPI-1).
NPI number1679770994
StatusActive
Last updated in NPPESOct 30, 2023
Details
- NPI
- 1679770994
- Entity type
- Individual (NPI-1)
- Name
- Charles Emmet Stout Jr.
- Credential
- MD, PhD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 29, 2007
- Certification date
- Oct 30, 2023
- Last updated
- Oct 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0204X | Radiology, Vascular & Interventional Radiology | A100577 | CA | Yes |
Practice location
4445 Magnolia AveRiverside, CA 92501-4135
Phone 951-338-4910 · Fax 833-996-0004
Mailing address
700 E Redlands Blvd # 714Redlands, CA 92373-6109
Phone 951-338-4910 · Fax 833-996-0004
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