Provider Demographics
NPI:1033186747
Name:NEUMANN, CHARLES A X (DO)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
Last Name:NEUMANN
Suffix:X
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 BALRA DR
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3302
Mailing Address - Country:US
Mailing Address - Phone:510-525-7705
Mailing Address - Fax:
Practice Address - Street 1:781 BALRA DR
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3302
Practice Address - Country:US
Practice Address - Phone:510-525-7705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-053128207P00000X
CA20A4150207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX41500Medicaid
CA00AX41500Medicaid
CABX617YMedicare PIN
CA020A41501Medicare PIN