Healthcare Provider Details

I. General information

NPI: 1205760675
Provider Name (Legal Business Name): CASEY CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 E HARDY ST
INGLEWOOD CA
90303-2271
US

IV. Provider business mailing address

3998 E HARDY ST
INGLEWOOD CA
90303-2271
US

V. Phone/Fax

Practice location:
  • Phone: 310-702-1883
  • Fax: 949-502-8887
Mailing address:
  • Phone: 310-702-1883
  • Fax: 949-502-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CASEY LEONARD CHARLTON
Title or Position: OWNER/ MD
Credential: MD
Phone: 310-702-1883