Provider Demographics
NPI:1548562697
Name:DEHA K KARAOGLAN
Entity Type:Organization
Organization Name:DEHA K KARAOGLAN
Other - Org Name:DEHA KARAOGLAN DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEHA
Authorized Official - Middle Name:KAYA
Authorized Official - Last Name:KARAOGLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:707-526-4777
Mailing Address - Street 1:1041 4TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4329
Mailing Address - Country:US
Mailing Address - Phone:707-526-4777
Mailing Address - Fax:707-526-8809
Practice Address - Street 1:1041 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4329
Practice Address - Country:US
Practice Address - Phone:707-526-4777
Practice Address - Fax:707-526-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4703213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty