Provider Demographics
NPI:1609851757
Name:MAAS, CHARLES WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:WILLIAM
Last Name:MAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1965 LIVE OAK BLVD
Mailing Address - Street 2:SUTTER-YUBA MENTAL HEATH YOUTH SERVICES
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-822-7513
Mailing Address - Fax:530-822-7514
Practice Address - Street 1:1965 LIVE OAK BLVD
Practice Address - Street 2:SUTTER-YUBA MENTAL HEATH YOUTH SERVICES
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-822-7513
Practice Address - Fax:530-822-7514
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG159052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G159050Medicaid