Provider Demographics
NPI:1740667575
Name:YOU, CHARLES
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:YOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S. LAFAYETTE PARK PL. APT229
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:267-968-4304
Mailing Address - Fax:
Practice Address - Street 1:420 S LA FAYETTE PARK PL
Practice Address - Street 2:APT.229
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1671
Practice Address - Country:US
Practice Address - Phone:267-968-4304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16520171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist