Provider Demographics
NPI:1639281306
Name:CHARLES E MCCARL MD
Entity Type:Organization
Organization Name:CHARLES E MCCARL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AND SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MCCARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:530-473-2113
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:969 E STREET
Mailing Address - City:WILLIAMS
Mailing Address - State:CA
Mailing Address - Zip Code:95987-0009
Mailing Address - Country:US
Mailing Address - Phone:530-473-2113
Mailing Address - Fax:530-473-5299
Practice Address - Street 1:969 E STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMS
Practice Address - State:CA
Practice Address - Zip Code:95987-0009
Practice Address - Country:US
Practice Address - Phone:530-473-2113
Practice Address - Fax:530-473-5299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA275540208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A25060Medicare UPIN
00A275540Medicare ID - Type Unspecified