Provider Demographics
NPI:1013165869
Name:VONTIEHL, KARL FRIEDRICH (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:FRIEDRICH
Last Name:VONTIEHL
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 1:375 HUNTINGTON DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2357
Mailing Address - Country:US
Mailing Address - Phone:626-460-6038
Mailing Address - Fax:877-886-6123
Practice Address - Street 1:375 HUNTINGTON DR
Practice Address - Street 2:SUITE C
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2357
Practice Address - Country:US
Practice Address - Phone:626-460-6038
Practice Address - Fax:877-886-6123
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95085207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology