Provider Demographics
NPI:1841250016
Name:NORTHFIELD, KARIN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KARIN
Middle Name:MARIE
Last Name:NORTHFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:800-883-7243
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:2240 N HARBOR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2634
Practice Address - Country:US
Practice Address - Phone:714-870-8300
Practice Address - Fax:714-870-8301
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63065207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G630651Medicaid
CAE41290Medicare UPIN
CA00G630651Medicaid
CACB253139Medicare PIN
CAG63065DMedicare PIN