Provider Demographics
NPI:1386646503
Name:SHERWOOD, KAREN ANNE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1346 FOOTHILL BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2141
Mailing Address - Country:US
Mailing Address - Phone:818-790-6726
Mailing Address - Fax:818-790-9562
Practice Address - Street 1:1346 FOOTHILL BLVD
Practice Address - Street 2:STE 203
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-2141
Practice Address - Country:US
Practice Address - Phone:818-790-6726
Practice Address - Fax:818-790-9562
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA42560207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A425600Medicaid
070008086OtherCHAMPUS
ZZZ15744ZOtherBLUE SHIELD
ZZZ15744ZOtherBLUE SHIELD