Provider Demographics
NPI:1750312427
Name:KARAPETIAN, MIKHAIL URI (MD)
Entity Type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:URI
Last Name:KARAPETIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:Y
Other - Last Name:KARAPETIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5220 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 'E'
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1234
Mailing Address - Country:US
Mailing Address - Phone:323-913-9300
Mailing Address - Fax:323-660-9723
Practice Address - Street 1:5220 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 'E'
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1234
Practice Address - Country:US
Practice Address - Phone:323-913-9300
Practice Address - Fax:323-660-9723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63531207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A635310Medicaid
CAA63531Medicare ID - Type Unspecified
CAA63531AMedicare ID - Type Unspecified
CAG90974Medicare UPIN