Ellis, Karen A

Ellis, Karen A is an individual health care provider with primary practice located at 501 S Buena Vista St , Burbank CA 91505-4809. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Ellis, Karen A can be contacted via phone (818) 847-4422.

Contact Information

Primary practice address
501 S Buena Vista St Burbank CA 91505-4809
Fax: (818) 847-4429
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X G54822 California

Profile Details

NPI number 1154315604
LBN Legal business name Ellis, Karen A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Oct 2nd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154315604 NPPES
California MEDICAID 00G548220

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