Provider Demographics
NPI:1437242252
Name:STOLAR, CHARLES JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JACOB
Last Name:STOLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2403 CASTILLO ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5316
Mailing Address - Country:US
Mailing Address - Phone:805-563-6560
Mailing Address - Fax:805-563-3680
Practice Address - Street 1:2403 CASTILLO ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5316
Practice Address - Country:US
Practice Address - Phone:805-563-6560
Practice Address - Fax:805-563-3680
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1503472086S0120X
CAG891302086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00741002.Medicaid
NY00741002.Medicaid