Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | DC21135 | CA |
Y | 213ER0200X | Radiology | DC21135 | CA |
NPI | 1770607210 |
---|---|
Provider Name | Suzan Diane Sterner |
First Address | Bakersfield, CA 93306-4246 |
Second Address | Bakersfield, CA 93306-4246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC21135 | LICENSE (01) | CA |