Provider Demographics
NPI:1558415042
Name:FORTE, KATHERINE ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELISE
Last Name:FORTE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:633 N CENTRAL AVE
Mailing Address - Street 2:#103
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1801
Mailing Address - Country:US
Mailing Address - Phone:818-241-1174
Mailing Address - Fax:818-241-3018
Practice Address - Street 1:633 N CENTRAL AVE
Practice Address - Street 2:#103
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1801
Practice Address - Country:US
Practice Address - Phone:818-241-1174
Practice Address - Fax:818-241-3018
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG037137207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology