Stevens, Charles Raymond

Stevens, Charles Raymond is an sole proprietor health care provider with primary practice located at 1665 S Imperial Ave Ste D , El Centro CA 92243-4247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Stevens, Charles Raymond can be contacted via phone (760) 482-0212.

Contact Information

Primary practice address
1665 S Imperial Ave Ste D El Centro CA 92243-4247
Fax: (760) 482-0166
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X A104563 California

Profile Details

NPI number 1003001363
LBN Legal business name Stevens, Charles Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 10th, 2007
Last updated May 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003001363 NPPES
California MEDICAID 7096338

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