Healthcare Provider Details

I. General information

NPI: 1831294933
Provider Name (Legal Business Name): SARAH COTTINGHAM KUEHN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S SEPULVEDA BLVD STE 210
MANHATTAN BEACH CA
90266-6877
US

IV. Provider business mailing address

1024 MORNINGSIDE DR APT 2
MANHATTAN BEACH CA
90266-5447
US

V. Phone/Fax

Practice location:
  • Phone: 310-374-5568
  • Fax:
Mailing address:
  • Phone: 310-874-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA91213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: