Healthcare Provider Details

I. General information

NPI: 1467486993
Provider Name (Legal Business Name): CHRISTINA MARIE CHARLES-SCHOEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA MARIE CHARLES

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PLAZA #365
LOS ANGELES CA
90074
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 200
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-2448
  • Fax:
Mailing address:
  • Phone: 310-825-2448
  • Fax: 310-206-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA78257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: