Healthcare Provider Details

I. General information

NPI: 1801085261
Provider Name (Legal Business Name): KARINA VANESSA FOSTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 SAN FERNANDO RD
GLENDALE CA
91202-2104
US

IV. Provider business mailing address

PO BOX 60790
PASADENA CA
91116-6790
US

V. Phone/Fax

Practice location:
  • Phone: 818-637-7766
  • Fax: 818-637-2650
Mailing address:
  • Phone: 626-795-6596
  • Fax: 626-795-8247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA99246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: