Provider Demographics
NPI:1619014750
Name:DOCTORS TELEHEALTH NETWORK CA
Entity type:Organization
Organization Name:DOCTORS TELEHEALTH NETWORK CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-553-0887
Mailing Address - Street 1:3723 BIRCH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2617
Mailing Address - Country:US
Mailing Address - Phone:949-553-0887
Mailing Address - Fax:
Practice Address - Street 1:3723 BIRCH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2617
Practice Address - Country:US
Practice Address - Phone:949-553-0887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A79972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty