Provider Demographics
NPI:1174617831
Name:KUENN, KARI (MD)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:KUENN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:KASSIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10940 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1600 - #939
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3915
Mailing Address - Country:US
Mailing Address - Phone:714-813-4022
Mailing Address - Fax:
Practice Address - Street 1:10940 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1600 - #939
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3915
Practice Address - Country:US
Practice Address - Phone:714-813-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61173310208000000X
ORMD208008208000000X
TXT1744208000000X
CAA555762080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A555760Medicaid
WA2207190Medicaid