Provider Demographics
NPI:1174291116
Name:GRUMAN, SARAH (IBCLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GRUMAN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CASADY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6236 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8383 WILSHIRE BLVD FL 8
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2425
Practice Address - Country:US
Practice Address - Phone:650-223-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-303362174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN