Provider Demographics
NPI:1720405897
Name:EASTMAN, KARINA (MD)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 HI POINT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2608
Mailing Address - Country:US
Mailing Address - Phone:310-926-9404
Mailing Address - Fax:
Practice Address - Street 1:2216 SANTA MONICA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2317
Practice Address - Country:US
Practice Address - Phone:310-264-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142031208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty