Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A91735 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A91735 | CA |
NPI | 1114172442 |
---|---|
Provider Name | Dr. Jeffrey D Suh |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2008 |
Last Update Date | 17/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A917350 | (05) | CA |