Provider Demographics
NPI:1184047243
Name:THE MEDICAL OFFICE OF DR CHARLES SKIBA INC
Entity type:Organization
Organization Name:THE MEDICAL OFFICE OF DR CHARLES SKIBA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SKIBA JR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:323-939-1603
Mailing Address - Street 1:PO BOX 462051
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-8051
Mailing Address - Country:US
Mailing Address - Phone:323-939-1603
Mailing Address - Fax:323-939-1643
Practice Address - Street 1:9229 WILSHIRE BLVD # 1
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5501
Practice Address - Country:US
Practice Address - Phone:323-939-1603
Practice Address - Fax:323-939-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty