Provider Demographics
NPI:1619066909
Name:CHAR, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CHAR
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1079 SUNRISE AVE STE B-321
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7009
Mailing Address - Country:US
Mailing Address - Phone:916-786-3222
Mailing Address - Fax:916-786-6636
Practice Address - Street 1:406 SUNRISE AVE STE 200
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4106
Practice Address - Country:US
Practice Address - Phone:916-786-3222
Practice Address - Fax:916-786-6636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2010-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA879372081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACE240ZMedicare PIN
CA128411Medicare UPIN