Healthcare Provider Details

I. General information

NPI: 1720163363
Provider Name (Legal Business Name): KAREN KARTUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9985 SIERRA AVE MOB 3 MODULE 3
FONTANA CA
92335-6720
US

IV. Provider business mailing address

9985 SIERRA AVE
FONTANA CA
92335-6720
US

V. Phone/Fax

Practice location:
  • Phone: 888-750-0036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG71674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: