Provider Demographics
NPI:1437680378
Name:LA CHARITE, JAIME MICHELLE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:MICHELLE
Last Name:LA CHARITE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:MICHELLE
Other - Last Name:GUILLOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2331
Mailing Address - Country:US
Mailing Address - Phone:951-310-8732
Mailing Address - Fax:
Practice Address - Street 1:8405 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3401
Practice Address - Country:US
Practice Address - Phone:410-522-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172122208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics