Kristin K. Egan MD Inc

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

A90465 Issued in CA

Legal business name

KRISTIN K. EGAN MD INC

Practice address

2809 N Sepulveda Blvd
Manhattan Beach, CA 90266-2727

Phone

(310) 796-4509

Fax

(310) 796-4513

NPI assigned

Nov 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kristin Egan, MDNPI 1669500302

Title

MD

Phone

(424) 241-3426

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristin Egan, M.D.

  • Facial Plastic Surgery Physician
  • Manhattan Beach, CA
  • NPI 1669500302
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1386946762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662727",
            "telephone_number": "310-796-4509",
            "fax_number": "310-796-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662727",
            "telephone_number": "310-796-4509",
            "fax_number": "310-796-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN K. EGAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "424-241-3426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A90465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kook, O.D.
• Sirine Koudsi, OD
• Adrianna Angelita Kovac-Vasquez, OTD, OTR/L
• Vicki Kraft
• Amy Lee Kramer, PT, DPT
• Sarah Cottingham Kuehn, M.D.
• Cindy Yung-Fang Kuo, DO
• Vanessa Kuriki, OD
• Nicholas Kutney, PT
• Michelle Kwak

• Facial Plastic Surgery Physician in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.