Basic Information
Provider Information
NPI: 1871972505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOEPFLIN
FirstName: CHARLES
MiddleName: WILTON
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10069
Address2:  
City: SAN BERNARDINO
State: CA
PostalCode: 924230069
CountryCode: US
TelephoneNumber: 9093354188
FaxNumber:  
Practice Location
Address1: 2 W FERN AVE
Address2:  
City: REDLANDS
State: CA
PostalCode: 923735916
CountryCode: US
TelephoneNumber: 9097860725
FaxNumber: 9095832598
Other Information
ProviderEnumerationDate: 05/27/2015
LastUpdateDate: 08/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA149828CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home