Healthcare Provider Details
I. General information
NPI: 1174617831
Provider Name (Legal Business Name): KARI KUENN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10940 WILSHIRE BLVD SUITE 1600 - #939
LOS ANGELES CA
90024-3915
US
IV. Provider business mailing address
10940 WILSHIRE BLVD SUITE 1600 - #939
LOS ANGELES CA
90024-3915
US
V. Phone/Fax
- Phone: 714-813-4022
- Fax:
- Phone: 714-813-4022
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD61173310 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD208008 |
| License Number State | OR |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | T1744 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | A55576 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: