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General NPI Number Information
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NPI Number | 1720112246
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Entity Type | Organization
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Legal Business Name | CHARLES A MULRY MD INC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8920 WILSHIRE BLVD SUITE 320
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2007
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Country | US
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Telephone | 310-289-2415
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Fax |
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Provider Business Mailing Address
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Address Line | 8920 WILSHIRE BLVD SUITE 320
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2007
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Country | US
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Telephone | 310-289-2415
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | GAIL LONG
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Credential |
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Telephone | 800-209-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | G10128
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License Number State | CA
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