Provider Demographics
NPI:1891089785
Name:SUNDHEIMER, LAUREN W (MD, MS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:W
Last Name:SUNDHEIMER
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 JAMBOREE RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2956
Mailing Address - Country:US
Mailing Address - Phone:949-222-1290
Mailing Address - Fax:
Practice Address - Street 1:3501 JAMBOREE RD STE 1100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2956
Practice Address - Country:US
Practice Address - Phone:949-222-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124809207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty