Charles Kaplove
Individual provider Active NPI Emergency Medicine Physician · Portola, CA
NPI 1114925898 · NPPES record last updated Dec 28, 2009
Key facts
- NPI
- 1114925898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- G42208 (CA)
- Practice address
- 500 1St Ave
Portola, CA 96122-9406 - Phone
- (530) 832-6500
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G42208 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkeley Emergency Medical Group, Inc. | Emergency Medicine | Past |
Accepting new patients |
| Berkeley Emergency Medical Group, Inc. | Emergency Medicine | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/91ce0f5a-eaec-4ac5-8575-4a3202e9921f/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G42208 | CA | Yes |
Addresses
Primary practice location
500 1St Ave
Portola, CA 96122-9406
Mailing address
500 1St Ave
Portola, CA 96122-9406
Phone (530) 832-6500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G422080 | Medicaid | CA |
Other providers in Portola, CA
- Mario G. Garibotti
- Richard Gepford
- Jeanne M. Harper
- Derry L. Hildebrand Jr.
- Richard D Hungerford
- Jeanne Kessler
- Kibble Enterprises, Inc.
- Bruce H Lee
- Sharon Malotte
- Patriot Counseling Services
All providers in Portola, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.