Provider Demographics
NPI:1740209303
Name:KARAMLOU, KATHY (MD)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:KARAMLOU
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:PO BOX 5688
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92616-5688
Mailing Address - Country:US
Mailing Address - Phone:949-631-6500
Mailing Address - Fax:949-631-9700
Practice Address - Street 1:361 HOSPITAL RD STE 428
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3525
Practice Address - Country:US
Practice Address - Phone:949-631-6500
Practice Address - Fax:949-631-9700
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72397207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A723970OtherMEDI-CAL
CAWA72397COtherMEDICARE INDIVIDUAL PTAN
CAW21789OtherMEDICARE GROUP PTAN
CA00A723970OtherMEDI-CAL