Provider Demographics
NPI:1053404517
Name:PARKO, KAREN LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:PARKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4 LAVERNE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-2273
Practice Address - Street 1:4150 CLEMENT STREET
Practice Address - Street 2:VAMC 127
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-2273
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG759702084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMQ9773Medicaid
AZ620741Medicaid
CO69885010Medicaid
NMQ9773Medicaid
AZ620741Medicaid
CO69885010Medicaid