Provider Demographics
NPI:1285755900
Name:CRAFT, CHARLES W (DPM)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:CRAFT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 W. SEVENTH ST.
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:559-584-5196
Mailing Address - Fax:559-584-9807
Practice Address - Street 1:806 W 7TH ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4926
Practice Address - Country:US
Practice Address - Phone:559-584-5196
Practice Address - Fax:559-584-9807
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000E32090213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1366570772OtherGROUP NPI NUMBER
CA0217680001Medicare NSC
CA1366570772OtherGROUP NPI NUMBER