Charles V. Ettari, M.D., Inc.

LBN: Charles V. Ettari, M.D., Inc.
Charles V. Ettari, M.D., Inc. is an health care organization with primary practice located at 9834 Genesee Ave , La Jolla CA 92037-1223. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Charles V. Ettari, M.D., Inc. can be contacted via phone (619) 277-9887, or through Daugherty, Shelly Lynn via phone (619) 277-9887.

Contact Information

Primary practice address
9834 Genesee Ave La Jolla CA 92037-1223
Phone: (619) 277-9887
Fax: (801) 253-9831
Website:
Map and Directions
Authorized official contact:
Name: Daugherty, Shelly Lynn
Phone: (619) 277-9887

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X G16786 California

Profile Details

NPI number 1629098520
LBN Legal business name Charles V. Ettari, M.D., Inc.
DBA Doing business as
Authorized official Daugherty, Shelly Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2006
Last updated Mar 4th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629098520 NPPES
California MEDICAID OOG167860

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