Provider Demographics
NPI:1144516345
Name:KARNO, CATHERINE KIM PHAN (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KIM PHAN
Last Name:KARNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:KIM
Other - Last Name:PHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1500 E TROPICANA AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6516
Mailing Address - Country:US
Mailing Address - Phone:775-682-0020
Mailing Address - Fax:702-995-6509
Practice Address - Street 1:1281 TERMINAL WAY STE 110
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3246
Practice Address - Country:US
Practice Address - Phone:775-682-0020
Practice Address - Fax:702-995-6509
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA259664207R00000X
NE28725208M00000X
WAMD60881129208M00000X
NV17480207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200621630AMedicaid
MO1144516345Medicaid
KS201123620BMedicaid
KS201123620BMedicaid