Basic Information
Provider Information
NPI: 1346449790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUTON
FirstName: KAREN
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 447 N EL MOLINO AVE
Address2:  
City: PASADENA
State: CA
PostalCode: 911011403
CountryCode: US
TelephoneNumber: 6265778480
FaxNumber: 6265778978
Practice Location
Address1: 6160 MISSION GORGE RD
Address2: SUITE 120
City: SAN DIEGO
State: CA
PostalCode: 921203410
CountryCode: US
TelephoneNumber: 6192822232
FaxNumber: 6192822992
Other Information
ProviderEnumerationDate: 07/16/2007
LastUpdateDate: 08/20/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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