Provider Demographics
NPI:1225225998
Name:CHARLES, STEVEN TUDOR (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TUDOR
Last Name:CHARLES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5963
Mailing Address - Country:US
Mailing Address - Phone:310-529-9307
Mailing Address - Fax:626-572-2120
Practice Address - Street 1:2200 PACIFIC COAST HWY
Practice Address - Street 2:HSUITE 304A
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2702
Practice Address - Country:US
Practice Address - Phone:310-529-9307
Practice Address - Fax:626-572-2120
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2022-02-18
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Provider Licenses
StateLicense IDTaxonomies
CAC 289912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry