Basic Information
| Provider Information | |||||||||
| NPI: | 1720110620 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DO | ||||||||
| FirstName: | SUZANNE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51238 | ||||||||
| Address2: | ATTN MAGGIE NOLES | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900515538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627414461 | ||||||||
| FaxNumber: | 5627414413 | ||||||||
| Practice Location | |||||||||
| Address1: | 11525 BROOKSHIRE AVE STE 301 | ||||||||
| Address2: | ATTN MAGGIE NOLES | ||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902414982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628623684 | ||||||||
| FaxNumber: | 5628627145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 07/16/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | NP 8206 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.