Provider Demographics
NPI:1801804737
Name:KARLS, MICHAEL S (PAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:KARLS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 CASTRO ST
Mailing Address - Street 2:332
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1010
Mailing Address - Country:US
Mailing Address - Phone:415-861-8627
Mailing Address - Fax:415-389-7455
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:332
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1010
Practice Address - Country:US
Practice Address - Phone:415-861-8627
Practice Address - Fax:415-389-7455
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P28356Medicare UPIN
CAOPA177890Medicare ID - Type Unspecified