Marc A Charles, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G40535 Issued in CA

Practice address

1501 North Harbor Blvd
203
Fullerton, CA 92835-3811

Phone

(714) 871-5411

Fax

(714) 871-2401

NPI assigned

Oct 4, 2006

Last updated

Dec 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

PsychiatryAlso: General Practice, Geriatric Psychiatry, Neurology

Education

University of California, Irvine, California College of Medicine, 1977

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marc a Charles MD Inc

  • Psychiatry Physician
  • Fullerton, CA
  • NPI 1457544207
  Medicare reassignment NPD Authorized official
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• County of Riverside

  dba Mental Health Inpatient Treatment Facility

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1780790436
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1316032386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NORTH HARBOR BLVD",
            "address_2": "203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353811",
            "telephone_number": "714-871-5411",
            "fax_number": "714-871-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NORTH HARBOR BLVD",
            "address_2": "203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353811",
            "telephone_number": "714-871-5411",
            "fax_number": "714-871-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G40535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Changela and Patel DDS, Inc. (Valencia Family Dental Care)
• Jonathan Alexander Chaparro
• Amy Lauren Chapman, M.A. SLP
• Storm Chapman
• Charles E. Groncy, MD Inc
• Sitipon Chavatipon, P.T.
• Roxana Chavez Amaya
• Alan Chavez
• Alejandra Chavez
• Angela Chavez

• Psychiatry Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.