Basic Information
| Provider Information | |||||||||
| NPI: | 1629002985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHRISTIE | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1206 STRAWBERRY VLG | ||||||||
| Address2: | |||||||||
| City: | MILL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949412372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153883364 | ||||||||
| FaxNumber: | 4153883385 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 REDWOOD HWY FRONTAGE RD | ||||||||
| Address2: | # 216 | ||||||||
| City: | MILL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949413034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153833500 | ||||||||
| FaxNumber: | 4153833554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 01/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | G80284 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.