Long, Charles Laurence

Long, Charles Laurence is an individual health care provider with primary practice located at 800 S Raymond Ave , Pasadena CA 91105-3229. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Long, Charles Laurence can be contacted via phone (626) 795-8051.

Contact Information

Primary practice address
800 S Raymond Ave Pasadena CA 91105-3229
Phone: (626) 795-8051
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A172378 California

Profile Details

NPI number 1780035220
LBN Legal business name Long, Charles Laurence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2016
Last updated Jul 2nd, 2024 - about last year

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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