Basic Information
Provider Information
NPI: 1619472891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOENBRUN
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018771
FaxNumber:  
Practice Location
Address1: 2020 SANTA MONICA BLVD STE 210
Address2:  
City: SANTA MONICA
State: CA
PostalCode: 904042139
CountryCode: US
TelephoneNumber: 3105826200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2018
LastUpdateDate: 10/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 10/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA166903CAY Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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