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General NPI Number Information
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NPI Number | 1992791503
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Entity Type | Individual
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Provider Name | CHARLES ANDREW REYNOLDS PHARM.D., B.C.P.P.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 9934 DONNA AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-1203
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Country | US
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Telephone | 818-701-5528
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Fax |
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Provider Business Mailing Address
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Address Line | 18017 CHATSWORTH ST # 376
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5608
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Country | US
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Telephone | 818-395-5366
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Fax |
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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 | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 35835
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License Number State | CA
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