Provider Demographics
NPI:1356316129
Name:JOSEPHSON, KAREN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:JOSEPHSON
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 1:8000 E BYNUM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3231
Mailing Address - Country:US
Mailing Address - Phone:323-309-0961
Mailing Address - Fax:562-795-5965
Practice Address - Street 1:8000 E BYNUM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3231
Practice Address - Country:US
Practice Address - Phone:323-309-0961
Practice Address - Fax:562-795-5965
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52102207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA008521020Medicaid
CA008521020Medicaid