Provider Demographics
NPI:1417093568
Name:CHARLES W. SPENLER, M.D., INC.
Entity Type:Organization
Organization Name:CHARLES W. SPENLER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-764-0644
Mailing Address - Street 1:PO BOX 940249
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-0249
Mailing Address - Country:US
Mailing Address - Phone:805-581-5575
Mailing Address - Fax:
Practice Address - Street 1:3440 LOMITA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4818
Practice Address - Country:US
Practice Address - Phone:310-764-0644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty