Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 142346 | CA |
NPI | 1285082859 |
---|---|
Provider Name | Dr. Daniel Suissa |
First Address | Beverly Hills, CA 90212-4801 |
Second Address | West Hollywood, CA 90069-3708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2016 |
Last Update Date | 22/05/2018 |