Provider Demographics
NPI:1326518325
Name:JOHNSTON, KAREN REYNOLDS (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:REYNOLDS
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:MUTCH
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:478 E CHARLESTON RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4235
Mailing Address - Country:US
Mailing Address - Phone:650-813-1471
Mailing Address - Fax:
Practice Address - Street 1:478 E CHARLESTON RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4235
Practice Address - Country:US
Practice Address - Phone:650-380-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67445207ZP0102X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology