Most Relevant Information
Provider Data
| NPI Number: | 1003584483 |
| Provider Name: | CHARLIE R NILAWAT |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | R1419560221 |
Most Important Dates
| Enumeration Date: | 09/01/2021 |
| Last Updated: | 09/01/2021 |
Provider Practice Location
100 E MARKET ST
LONG BEACH
CA
908055924
Practice Location Phone/Fax
| Phone: | 5624284222 |
| Fax: | 5624280372 |
Provider Mailing Location
100 E MARKET ST
LONG BEACH
CA
908055924
Provider Mailing Phone/Fax
| Phone: | 5624284222 |
| Fax: | 5624280372 |