Provider Demographics
NPI:1477723211
Name:MURPHY, CHARLES L (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:168 N BRENT ST
Mailing Address - Street 2:STE 502
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2817
Mailing Address - Country:US
Mailing Address - Phone:805-641-2000
Mailing Address - Fax:805-641-5869
Practice Address - Street 1:168 N BRENT ST
Practice Address - Street 2:STE 502
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2817
Practice Address - Country:US
Practice Address - Phone:805-641-2000
Practice Address - Fax:805-641-5869
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA99577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA99577OtherSTATE MEDICAL LIC