Healthcare Provider Details

I. General information

NPI: 1215170303
Provider Name (Legal Business Name): CHARLES JOSEPH MCGRAW JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 WARING RD STE C
OCEANSIDE CA
92056-4455
US

IV. Provider business mailing address

1955 CITRACADO PKWY STE 100
ESCONDIDO CA
92029-4111
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-3685
  • Fax: 760-940-4032
Mailing address:
  • Phone: 760-940-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME117653
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA115348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: