Provider Demographics
NPI:1780653782
Name:CUEVA, SARAH GRACE (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:CUEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GRACE
Other - Last Name:COATS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:550 ORTEGA AVE
Mailing Address - Street 2:APT 226
Mailing Address - City:MT VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1500
Mailing Address - Country:US
Mailing Address - Phone:650-964-7494
Mailing Address - Fax:
Practice Address - Street 1:751 S BASCOM AVE
Practice Address - Street 2:PEDIATRICS DEPT
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2604
Practice Address - Country:US
Practice Address - Phone:408-885-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76801208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A768010Medicaid
CA00A768015Medicare ID - Type Unspecified
CA00A768010Medicaid