Basic Information
Provider Information
NPI: 1316164015
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASSEL
FirstName: SUZANNE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8700 BEVERLY BLVD
Address2:  
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 3104233277
FaxNumber: 3193568280
Practice Location
Address1: 8700 BEVERLY BLVD
Address2:  
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 3104233277
FaxNumber: 3193568280
Other Information
ProviderEnumerationDate: 04/20/2007
LastUpdateDate: 05/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207K00000X042784CTN Allopathic & Osteopathic PhysiciansAllergy & Immunology 
207R00000X37605IAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RA0201X37605IAN Allopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
207K00000XC143748CAY Allopathic & Osteopathic PhysiciansAllergy & Immunology 

No ID Information.


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