Basic Information
| Provider Information | |||||||||
| NPI: | 1316371446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METCALFE | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S FREMONT AVE | ||||||||
| Address2: | BLDG A7, STE 7333, UNIT 86 | ||||||||
| City: | ALHAMBRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 918038800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264574123 | ||||||||
| FaxNumber: | 6264574125 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 EASTLAKE AVE | ||||||||
| Address2: | NORRIS 7416 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900890112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104255109 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2013 | ||||||||
| LastUpdateDate: | 10/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | A 127075 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.