Provider Demographics
NPI:1780627190
Name:HASTINGS, CHARLES JOHN (DPM, FACFAS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOHN
Last Name:HASTINGS
Suffix:
Gender:M
Credentials:DPM, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W HUNTINGTON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-1527
Mailing Address - Country:US
Mailing Address - Phone:626-821-9323
Mailing Address - Fax:626-821-9325
Practice Address - Street 1:301 W HUNTINGTON DR STE 300
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1527
Practice Address - Country:US
Practice Address - Phone:626-821-9323
Practice Address - Fax:626-821-9325
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300959213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10009569OtherOPTIMA
VA221657OtherANTHEM
VA010306981Medicaid
VA221657OtherANTHEM
VA10995M52Medicare PIN