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General NPI Number Information
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NPI Number | 1104088681
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Entity Type | Organization
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Legal Business Name | ALAN CHARNELLE MD
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 9561 VAN NUYS BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-1344
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Country | US
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Telephone | 818-892-4301
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Fax | 818-891-7996
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Provider Business Mailing Address
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Address Line | 9561 VAN NUYS BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-1344
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Country | US
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Telephone | 818-892-4301
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Fax | 818-891-7996
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN CHARNELLE
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Credential | M.D.
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Telephone | 818-892-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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