Provider Demographics
NPI:1083616031
Name:VIRLEY, KAREN I (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:I
Last Name:VIRLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8510 BALBOA BLVD 150
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5810
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-654-3417
Practice Address - Street 1:12660 RIVERSIDE DR
Practice Address - Street 2:STE 310
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-3431
Practice Address - Country:US
Practice Address - Phone:818-755-0391
Practice Address - Fax:818-753-8165
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG83474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G834740Medicaid
CAWG83474AMedicare PIN
CAF60027Medicare UPIN