Provider Demographics
NPI:1568444842
Name:KARNS, ROBERT MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MITCHELL
Last Name:KARNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67544
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-0544
Mailing Address - Country:US
Mailing Address - Phone:310-652-8084
Mailing Address - Fax:310-277-8935
Practice Address - Street 1:1125 S BEVERLY DR
Practice Address - Street 2:STE 720
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1148
Practice Address - Country:US
Practice Address - Phone:310-652-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72770207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G72770Medicaid
952622590OtherTAX ID#
952622590OtherTAX ID#
CA000G72770Medicaid
CA00WG7277BMedicare PIN