Provider Demographics
NPI:1528301462
Name:JENSEN, KRISTIN SCHWAB (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:SCHWAB
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:ELISE
Other - Last Name:SCHWAB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2025 4TH ST UNIT 205A
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1142
Mailing Address - Country:US
Mailing Address - Phone:410-808-6611
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:SUITE 7501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8358
Practice Address - Country:US
Practice Address - Phone:310-825-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133931207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine