MEDICARE: ELIAS KARIMYAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	VN682384	CA
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	95186115	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326529348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIAS KARIMYAR

Provider Business Mailing Address
First Line	:	212 W AVENIDA DE LAS FLORES
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1803
Country	:	US
Telephone Number	:	805-405-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 W AVENIDA DE LAS FLORES
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1803
Country	:	US
Telephone Number	:	805-405-3156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	05/28/2020

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Directions to “ ELIAS KARIMYAR ” Practice Location

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