CHARLES A BLAINE II (NPI# 1811088578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811088578 |
| Entity Type | Individual |
| Full Name | CHARLES A BLAINE II |
| Credential | DPM |
| Practice Address |
1510 S Central Ave Suite 120 Glendale CA 91204 |
| Mailing Address |
1510 S Central Ave 120 Glendale CA 91204 |
| Practice Telephone | 8182423668 |
| Practice Fax Number | 8182422425 |
| Mailing Telephone | 8182423668 |
| Mailing Fax Number | 8182422425 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E3817 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 000E38170 | 05 | |
| RAILROAD | 480016633 | 01 |
| Street Address |
1510 S CENTRAL AVE SUITE 120 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124020136 | Richard W Suda | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1510 S Central Ave, Suite 530, Glendale, CA 91204-2500 | 2005-08-10 |
| 1912381294 | Kyrillos Medical Group,inc | Specialist | 1510 S Central Ave, Suite 250, Glendale, CA 91204-2500 | 2015-07-16 |
| 1942699236 | Major Medical Management, Inc. | Clinic/Center | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2500 | 2015-01-09 |
| 1124449384 | Mardi H. Mihranian | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1922429182 | Susan L. Chobanian, M.d. | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1861834178 | Ivan Brando Teves Aguilera | Podiatrist | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2576 | 2013-07-28 |
| 1205176690 | Global Research Management, Inc | Specialist | 1510 S Central Ave, Suite 300, Glendale, CA 91204-2500 | 2013-02-21 |
| 1013206945 | Yen Tun Wang | Dermatology | 1510 S Central Ave, Suite 470, Glendale, CA 91204-2500 | 2011-03-31 |
| 1902105059 | Amandeep Kaur Randhawa | Podiatrist | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2011-03-15 |
| 1952543886 | Nathan Malcolm Miller | Chiropractor | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2009-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1972133387 | Yusuf Toliver | Counselor | 1027 S Central Ave, Suite 200, Glendale, CA 91204 | 2020-01-24 |
| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
| Find all providers in zip 91204 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154602399 | Sole Care LLC | Podiatrist | 5660 W Potter Dr, Glendale, AZ 85308-9164 | 2011-09-01 |
| 1811166341 | Spyros Tsoumpariotis | Podiatrist | 7901 Myrtle Ave, Glendale, NY 11385-7441 | 2008-02-28 |
| 1164608394 | Joseph Addiego | Podiatrist | 1510 S Central Ave Ste 120, Glendale, CA 91204-2576 | 2008-01-17 |
| 1073660353 | Glenoaks Podiatry Group Inc | Podiatrist | 844 West Glenoaks Blvd, Glendale, CA 91202-2134 | 2007-01-05 |
| 1417032863 | Spyros Tsoumpariotis | Podiatrist | 79-01 Myrtle Ave, Glendale, NY 11385 | 2006-10-26 |
| 1700968377 | Thunderbird Podiatry | Podiatrist | 5620 W Thunderbird, G2, Glendale, AZ 85306 | 2006-10-20 |
| 1124112255 | Jeffrey Howard Stark | Podiatrist | 6216 Myrtle Ave, Glendale, NY 11385-6236 | 2006-10-03 |
| 1205937133 | Andrew C La | Podiatrist | 1510 S Central Ave #120, Glendale, CA 91204-2577 | 2006-09-25 |
| 1619076924 | George Nirvano Thompson Sr. | Podiatrist | 5757 West Thunderbird Road, Suite W203, Glendale, AZ 85306-4649 | 2006-09-22 |
| 1790713493 | Frank J Garofalo | Podiatrist | 1101 N Pacific Ave Ste 104, Glendale, CA 91202-4313 | 2006-06-29 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on CHARLES A BLAINE II.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.