Healthcare Provider Details

I. General information

NPI: 1508861634
Provider Name (Legal Business Name): CHARLES E LINDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18364 CLARK ST
TARZANA CA
91356-3502
US

IV. Provider business mailing address

18364 CLARK ST
TARZANA CA
91356-3502
US

V. Phone/Fax

Practice location:
  • Phone: 818-345-7122
  • Fax: 818-345-7448
Mailing address:
  • Phone: 818-345-7122
  • Fax: 818-345-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG42744
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberG42744
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: