Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A140211 | CA |
NPI | 1003174368 |
---|---|
Provider Name | Dr. Charles Minh |
First Address | Torrance, CA 90510-3129 |
Second Address | Tustin, CA 92780-6057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 25/07/2016 |