Provider Demographics
NPI:1508861535
Name:ZOLLER, KAREN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:ZOLLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3780 KILROY AIRPORT WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2458
Mailing Address - Country:US
Mailing Address - Phone:562-595-7426
Mailing Address - Fax:562-989-3054
Practice Address - Street 1:3780 KILROY AIRPORT WAY STE 115
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806
Practice Address - Country:US
Practice Address - Phone:562-595-7426
Practice Address - Fax:562-989-3054
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG37085207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG37085Medicaid
CAA46947Medicare UPIN
CAWG37085CMedicare PIN