Provider Demographics
NPI:1700112588
Name:VANOORDT, KAREN GUISELLA (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GUISELLA
Last Name:VANOORDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 E DYER RD STE 145
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5694
Mailing Address - Country:US
Mailing Address - Phone:888-277-0080
Mailing Address - Fax:
Practice Address - Street 1:1241 E DYER RD STE 145
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5694
Practice Address - Country:US
Practice Address - Phone:888-277-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301505119207Q00000X
CAA61048207Q00000X
CAA61408208000000X, 208D00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care