Provider Demographics
NPI:1902924905
Name:CHARLES M. GARNER, M.D.
Entity Type:Organization
Organization Name:CHARLES M. GARNER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-696-1145
Mailing Address - Street 1:14350 E. WHITTIER BLVD.
Mailing Address - Street 2:325
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2151
Mailing Address - Country:US
Mailing Address - Phone:562-696-1145
Mailing Address - Fax:562-696-3772
Practice Address - Street 1:14350 WHITTIER BLVD
Practice Address - Street 2:325
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2138
Practice Address - Country:US
Practice Address - Phone:562-696-1145
Practice Address - Fax:562-696-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63750208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX I.D.