Individual
KAREN A ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 847-4422
(818) 847-4429
Mailing address
PO BOX 2311, CHATSWORTH, CA 91313-2311
(818) 718-9500
(818) 718-9507
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G54822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G548220
—
CA
Enumeration date
09/09/2005
Last updated
10/02/2007
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