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Individual

KAREN JEAN MCILVENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1812 VERDUGO BLVD, GLENDALE, CA 91208-1407
(818) 952-2214
(818) 952-4618
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A46524
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A465240
BLUE SHIELD
CA
05
00A65240
CA
Enumeration date
07/30/2006
Last updated
07/08/2007
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