Provider Demographics
NPI:1942477070
Name:KARMACHARYA, MUKUNDA RAM
Entity Type:Individual
Prefix:
First Name:MUKUNDA
Middle Name:RAM
Last Name:KARMACHARYA
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 1:5871 COMPASS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1703
Mailing Address - Country:US
Mailing Address - Phone:310-595-4504
Mailing Address - Fax:310-417-7978
Practice Address - Street 1:5871 COMPASS DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1703
Practice Address - Country:US
Practice Address - Phone:310-595-4504
Practice Address - Fax:310-417-7978
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC008471171100000X
AZAC0263171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist