Provider Demographics
NPI:1003001728
Name:KAREN L . VAUSE MD INC
Entity Type:Organization
Organization Name:KAREN L . VAUSE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:VAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-995-0640
Mailing Address - Street 1:PO BOX 261791
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91426-1791
Mailing Address - Country:US
Mailing Address - Phone:818-995-0640
Mailing Address - Fax:818-881-7566
Practice Address - Street 1:16677 CALNEVA DR
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4167
Practice Address - Country:US
Practice Address - Phone:818-995-0640
Practice Address - Fax:818-881-7566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW22527OtherMEDICARE GROUP PTAN