Healthcare Provider Details

I. General information

NPI: 1417093568
Provider Name (Legal Business Name): CHARLES W. SPENLER, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 LOMITA BLVD STE 220
TORRANCE CA
90505-4818
US

IV. Provider business mailing address

PO BOX 940249
SIMI VALLEY CA
93094-0249
US

V. Phone/Fax

Practice location:
  • Phone: 310-764-0644
  • Fax:
Mailing address:
  • Phone: 805-581-5575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES SPENLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-764-0644