MEDICARE: DR. CHARLES A. AUBREY EUBANKS 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	2084P0800X	Psychiatry Physician	C33728	CA

General Provider Information

NPI Number	:	1588823496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES A. AUBREY EUBANKS M.D.

Provider Business Mailing Address
First Line	:	970 CAMERADO DR
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7636
Country	:	US
Telephone Number	:	530-677-4405
Fax Number	:	530-677-5736

Provider Business Practice Location Address
First Line	:	970 CAMERADO DR
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7636
Country	:	US
Telephone Number	:	530-677-4405
Fax Number	:	530-677-5736

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	06/05/2008

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