Provider Demographics
NPI:1932514239
Name:KIN, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:KIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10855 CHURCH ST APT 2304
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8593
Mailing Address - Country:US
Mailing Address - Phone:301-455-2255
Mailing Address - Fax:
Practice Address - Street 1:1499 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4611
Practice Address - Country:US
Practice Address - Phone:855-422-8029
Practice Address - Fax:909-883-1683
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA163707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine