Basic Information
| Provider Information | |||||||||
| NPI: | 1447205919 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARROUM | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 NORTH HOLLYWOOD WAY | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915055019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185570135 | ||||||||
| FaxNumber: | 8185571394 | ||||||||
| Practice Location | |||||||||
| Address1: | 4081 EAST OLYMPIC BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900233330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238812666 | ||||||||
| FaxNumber: | 3232674530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A34648 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00A346480 | 01 | CA | CALOPTIMA | OTHER | 00A346480 | 05 | CA | MEDICAID | 00A346480 | 01 | CA | BLUE SHIELD | OTHER | 050663CA84673 | 01 | CA | LA COMMUNITY TRAILBLAZER | OTHER | A34648 | 01 | CA | BLUE CROSS | OTHER |