Provider Demographics
NPI:1992898597
Name:PURCELL, KAREN JEAN (MD, PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DR STE 212
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1551
Mailing Address - Country:US
Mailing Address - Phone:408-628-0783
Mailing Address - Fax:
Practice Address - Street 1:555 KNOWLES DR STE 212
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1551
Practice Address - Country:US
Practice Address - Phone:408-628-0783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74746207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH97914Medicare UPIN
CA00A747460Medicare PIN