Provider Demographics
NPI:1033135488
Name:GABOIAN, KARINE (MD)
Entity Type:Individual
Prefix:
First Name:KARINE
Middle Name:
Last Name:GABOIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N BRAND BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2583
Mailing Address - Country:US
Mailing Address - Phone:818-247-9717
Mailing Address - Fax:818-247-9760
Practice Address - Street 1:1141 N BRAND BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2511
Practice Address - Country:US
Practice Address - Phone:818-247-9717
Practice Address - Fax:818-247-9760
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80337208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH72398Medicare UPIN