Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G411548 | CA |
NPI | 1114906435 |
---|---|
Provider Name | Dr. Lorilee Smith Sutter |
First Address | Modesto, CA 95350-4046 |
Second Address | Modesto, CA 95350-4046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 07/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1114906435 | NPI (01) | CA |
A48608 | (02) |