Provider Demographics
NPI:1528230158
Name:STEPANYAN, KARO
Entity Type:Individual
Prefix:
First Name:KARO
Middle Name:
Last Name:STEPANYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11652 VICTORY BLVD UNIT C
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3514
Mailing Address - Country:US
Mailing Address - Phone:818-508-0157
Mailing Address - Fax:818-505-0940
Practice Address - Street 1:11652 VICTORY BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3514
Practice Address - Country:US
Practice Address - Phone:818-508-0157
Practice Address - Fax:818-505-0940
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4300110001Medicare NSC