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General NPI Number Information
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NPI Number | 1447317771
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Entity Type | Individual
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Provider Name | KIMBERLY ANN CHARLTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 1400 S GRAND AVE STE 801
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City | LOS ANGELES
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State | CA
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Zip | 90015-3068
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Country | US
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Telephone | 213-741-9727
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Fax | 213-741-0867
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Provider Business Mailing Address
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Address Line | 6255 W SUNSET BLVD FL 21
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City | LOS ANGELES
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State | CA
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Zip | 90028-7422
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Country | US
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Telephone | 323-498-6674
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Fax | 855-312-7678
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0051678
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD11530
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | DR.0051678
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G88843
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License Number State | CA
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