Provider Demographics
NPI:1740414606
Name:RUNGE, SARA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JEAN
Last Name:RUNGE
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 1:3350 E 7TH ST # 419
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5003
Mailing Address - Country:US
Mailing Address - Phone:213-281-9405
Mailing Address - Fax:
Practice Address - Street 1:3350 E 7TH ST # 419
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5003
Practice Address - Country:US
Practice Address - Phone:213-281-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1075772086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery