Healthcare Provider Details

I. General information

NPI: 1235292376
Provider Name (Legal Business Name): ROBERT J CHARLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13889 FOLSOM BLVE, STE 300 - 265
FOLSOM CA
95630
US

IV. Provider business mailing address

13389 FOLSOM BLVD STE 300-265
FOLSOM CA
95630-8057
US

V. Phone/Fax

Practice location:
  • Phone: 916-537-6459
  • Fax:
Mailing address:
  • Phone: 916-537-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA71846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: