Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 106559-4201 | UT |
NPI | 1386645075 |
---|---|
Provider Name | Susan S Ozaki |
First Address | Salt Lake City, UT 84117-6657 |
Second Address | Salt Lake City, UT 84117-6601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 04/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1108540001 | CIGNA DMERC (01) | UT |
3603837001 | CIGNA (01) | UT |
5417 | DMBA (01) | UT |
6400150 | UNITED HEALTHCARE (01) | UT |
68951 | PEHP (01) | UT |
870388269BR1 | EDUCATORS MUTUAL (01) | UT |
88106559403001 | BLUE CROSS BLUE SHIELD (01) | UT |
CJ9402 | RAILROAD MEDICARE (01) | UT |
P47545 | (02) | UT |
QM000004843 | ALTIUS (01) | UT |