Healthcare Provider Details

I. General information

NPI: 1174611099
Provider Name (Legal Business Name): SARAH CHRISTIAN EGAN CNM, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 11/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WILSHIRE BLVD 8TH FLOOR
LOS ANGELES CA
90017-1901
US

IV. Provider business mailing address

1614 FREMONT AVE
SOUTH PASADENA CA
91030-4407
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-4120
  • Fax:
Mailing address:
  • Phone: 917-716-6235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF#001080-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: