Provider Demographics
NPI:1487695136
Name:MEHRINGER, CHARLES M (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:MEHRINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:21840 NORMANDIE AVE
Mailing Address - Street 2:STE. 500
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2047
Mailing Address - Country:US
Mailing Address - Phone:310-222-5163
Mailing Address - Fax:310-222-5173
Practice Address - Street 1:21840 NORMANDIE AVE
Practice Address - Street 2:STE. 500
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2047
Practice Address - Country:US
Practice Address - Phone:310-222-5163
Practice Address - Fax:310-222-5173
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG210772085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G210770Medicaid
CAWG21077JMedicare PIN
CAWG21007IMedicare PIN
CAA41171Medicare UPIN
CAWG21077HMedicare PIN