Healthcare Provider Details

I. General information

NPI: 1649328220
Provider Name (Legal Business Name): RENE S. CHARLES MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 N VERMONT AVE
DINUBA CA
93618-1631
US

IV. Provider business mailing address

342 N VERMONT AVE
DINUBA CA
93618-1631
US

V. Phone/Fax

Practice location:
  • Phone: 559-591-7229
  • Fax: 559-596-2085
Mailing address:
  • Phone: 559-591-7229
  • Fax: 559-596-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: RITA NYE
Title or Position: BILLING SUPER
Credential:
Phone: 559-783-1181