Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 47567 | CA |
Y | 213EG0000X | General Practice | 47567 | CA |
NPI | 1003034059 |
---|---|
Provider Name | Ricardo Andres Suarez |
First Address | Whittier, CA 90605-1325 |
Second Address | West Covina, CA 91790-2902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/09/2019 |