Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A147454 | CA |
Y | 2080P0203X | Pediatric Critical Care Doctor | A147454 | CA |
NPI | 1194104521 |
---|---|
Provider Name | Charles E Pohl III |
First Address | Pasadena, CA 91106-0600 |
Second Address | Duarte, CA 91010-3012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2015 |
Last Update Date | 07/11/2021 |