Provider Demographics
NPI:1326128851
Name:EPSTEIN, KARL ELLIOTT (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:ELLIOTT
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CANOGA AVE
Mailing Address - Street 2:#101
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:818-884-6200
Mailing Address - Fax:818-884-6226
Practice Address - Street 1:6400 CANOGA AVE
Practice Address - Street 2:#101
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-884-6200
Practice Address - Fax:818-884-6226
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38862207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A47622Medicare UPIN
G38862Medicare ID - Type Unspecified
CA38862Medicare PIN
CAA47622Medicare UPIN