Healthcare Provider Details

I. General information

NPI: 1417930603
Provider Name (Legal Business Name): SARA RACHAEL KOSSUTH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6442 PLATT AVE STE 513
WEST HILLS CA
91307-3216
US

IV. Provider business mailing address

6442 PLATT AVE STE 513
WEST HILLS CA
91307-3216
US

V. Phone/Fax

Practice location:
  • Phone: 310-490-7759
  • Fax: 818-887-2285
Mailing address:
  • Phone: 310-490-7759
  • Fax: 818-887-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number20A8025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number20A8025
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A8025
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number20A8025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: