Healthcare Provider Details

I. General information

NPI: 1780783530
Provider Name (Legal Business Name): KAREN VOSSEN SMIRNAKIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AMGEN CENTER DR MS 17-5-A
THOUSAND OAKS CA
91320-1730
US

IV. Provider business mailing address

1 AMGEN CENTER DR MS 27 5-A
THOUSAND OAKS CA
91320-1730
US

V. Phone/Fax

Practice location:
  • Phone: 805-447-9374
  • Fax:
Mailing address:
  • Phone: 805-447-9374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number161002
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: