Provider Demographics
NPI:1881753366
Name:SOPHY, CHARLES JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOSEPH
Last Name:SOPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:425 SHATTO PL
Mailing Address - Street 2:500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1712
Mailing Address - Country:US
Mailing Address - Phone:213-351-5614
Mailing Address - Fax:213-738-8340
Practice Address - Street 1:425 SHATTO PL
Practice Address - Street 2:500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1712
Practice Address - Country:US
Practice Address - Phone:213-351-5614
Practice Address - Fax:213-738-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA20A62052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry