Provider Demographics
NPI: | 1164972436 |
---|---|
Name: | ANOUKI N KARU, MD, INC |
Entity Type: | Organization |
Organization Name: | ANOUKI N KARU, MD, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/ SOLE OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANOUKI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KARU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 818-888-7815 |
Mailing Address - Street 1: | PO BOX 7001 |
Mailing Address - Street 2: | |
Mailing Address - City: | TARZANA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91357-7001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 818-888-7815 |
Mailing Address - Fax: | 818-715-1722 |
Practice Address - Street 1: | 2601 W ALAMEDA AVE |
Practice Address - Street 2: | STE.#312 |
Practice Address - City: | BURBANK |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91505-4800 |
Practice Address - Country: | US |
Practice Address - Phone: | 818-842-9728 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-10 |
Last Update Date: | 2016-10-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A104046 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Single Specialty |