Provider Demographics
NPI:1912930884
Name:EPSTEIN, SARA ANN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:EPSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:450 N BRAND BLVD
Mailing Address - Street 2:FL.6 RM.66
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203
Mailing Address - Country:US
Mailing Address - Phone:323-600-4529
Mailing Address - Fax:818-291-6221
Practice Address - Street 1:450 N BRAND BLVD
Practice Address - Street 2:FL.6 RM.66
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203
Practice Address - Country:US
Practice Address - Phone:323-600-4529
Practice Address - Fax:818-291-6221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG399612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G399610Medicaid
CAZZZ60515ZOtherBLUE SHIELD
CAG39961BMedicare ID - Type Unspecified