MEDICARE: DR. CHARLES RAYMOND STEVENS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	A104563	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003001363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES RAYMOND STEVENS M.D.

Provider Business Mailing Address
First Line	:	1665 S IMPERIAL AVE STE D
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-4247
Country	:	US
Telephone Number	:	760-482-0212
Fax Number	:	760-482-0166

Provider Business Practice Location Address
First Line	:	1665 S IMPERIAL AVE STE D
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-4247
Country	:	US
Telephone Number	:	760-482-0212
Fax Number	:	760-482-0166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	05/11/2021

Similar Medicare Providers

1558209064 — CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC
Practice Location Address:

1665 S IMPERIAL AVE STE C
EL CENTRO, CA
92243-4247

Practice Phone: 760-335-4943
Practice Fax: 760-337-8400

1982696969 — VALLOP KANJANAPONE M.D.
Practice Location Address:

1665 S IMPERIAL AVE
EL CENTRO, CA
92243-4247

Practice Phone: 760-352-7216
Practice Fax: 760-352-1028

1104018159 — CHARLES R STEVENS M.D, APC
Practice Location Address:

1665 S IMPERIAL AVE STE D
EL CENTRO, CA
92243-4247

Practice Phone: 760-482-0212
Practice Fax: 760-482-0166

1386973097 — ADVANCE PHYSICAL THERAPY CENTER
Practice Location Address:

1665 S IMPERIAL AVE STE C
EL CENTRO, CA
92243-4247

Practice Phone: 760-337-8300
Practice Fax: 760-337-8400

1316323736 — ARTURO GARCIA PA-C
Practice Location Address:

1665 S IMPERIAL AVE STE D
EL CENTRO, CA
92243-4247

Practice Phone: 760-482-0212
Practice Fax: 760-482-0166

1891561213 — REBEKKA YVETTE LERMA FNP
Practice Location Address:

1665 SOUTH IMPERIAL AVENUE , SUITE C
EL CENTRO, CA
92243-4247

Practice Phone: 760-592-4783
Practice Fax: 760-545-0256

Directions to “ DR. CHARLES RAYMOND STEVENS M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.