Provider Demographics
NPI:1558470674
Name:STEWART, SARA T (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:T
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1000 W CARSON ST
Mailing Address - Street 2:BUILDING N-26, BOX 460
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2004
Mailing Address - Country:US
Mailing Address - Phone:310-222-3567
Mailing Address - Fax:310-320-7849
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:BUILDING N-26
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-3567
Practice Address - Fax:310-320-7849
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA62723208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH52673Medicare UPIN
CAWA62723CMedicare PIN
CAWA62723BMedicare PIN