Basic Information
Provider Information
NPI: 1154384303
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARPOUZAS
FirstName: GEORGE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21840 NORMANDIE AVE
Address2: STE. 700
City: TORRANCE
State: CA
PostalCode: 905022047
CountryCode: US
TelephoneNumber: 3102225101
FaxNumber: 3103205463
Practice Location
Address1: 21840 NORMANDIE AVE
Address2: STE. 700
City: TORRANCE
State: CA
PostalCode: 905022047
CountryCode: US
TelephoneNumber: 3102225101
FaxNumber: 3103205463
Other Information
ProviderEnumerationDate: 04/10/2006
LastUpdateDate: 02/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XA63587CAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
130682531001CAGROUP NPIOTHER
W1494001CAGROUPOTHER


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