Provider Demographics
NPI:1033129820
Name:SALINGER, INC, CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:SALINGER, INC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12675 LA MIRADA BLVD
Mailing Address - Street 2:STE # 215
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:562-941-8753
Mailing Address - Fax:562-946-2970
Practice Address - Street 1:12675 LA MIRADA BLVD
Practice Address - Street 2:STE # 215
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2200
Practice Address - Country:US
Practice Address - Phone:562-941-8753
Practice Address - Fax:562-946-2970
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26300207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG26300Medicare ID - Type Unspecified
A42969Medicare UPIN