Provider Demographics
NPI:1215033808
Name:MAPLES, CHARLES M (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:M
Last Name:MAPLES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3771 KATELLA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3111
Mailing Address - Country:US
Mailing Address - Phone:562-430-6850
Mailing Address - Fax:562-430-6820
Practice Address - Street 1:3771 KATELLA AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3108
Practice Address - Country:US
Practice Address - Phone:562-430-6850
Practice Address - Fax:562-430-6820
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G60207Medicare UPIN