Provider Demographics
NPI:1447427844
Name:CHILOMBO, KARAMO (MD)
Entity Type:Individual
Prefix:
First Name:KARAMO
Middle Name:
Last Name:CHILOMBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KARAMO
Other - Middle Name:
Other - Last Name:CHILOMBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3533 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-4534
Mailing Address - Country:US
Mailing Address - Phone:323-734-1600
Mailing Address - Fax:
Practice Address - Street 1:3533 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-4534
Practice Address - Country:US
Practice Address - Phone:323-734-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32930207Q00000X, 207R00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology