Provider Demographics
NPI:1881698702
Name:KAPLAN, KARL K (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:K
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 FLOWER ST
Mailing Address - Street 2:STE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3000
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-242-8761
Practice Address - Street 1:15211 VANOWEN ST
Practice Address - Street 2:STE 206
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3620
Practice Address - Country:US
Practice Address - Phone:818-376-1155
Practice Address - Fax:818-376-0011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G460450Medicaid
CAWG46045GMedicare ID - Type Unspecified
CA00G460450Medicaid