Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A42275 | CA |
Y | 111NI0900X | Internist | A42275 | CA |
N | 207T00000X | Neurosurgeon | A42275 | CA |
NPI | 1003902511 |
---|---|
Provider Name | Zoraida I Suarez |
First Address | Encino, CA 91316 |
Second Address | Encino, CA 91316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 05/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A422750 | (05) | CA |
200504600 | DPT OF LABOR (01) | CA |
A29545 | (02) | CA |
ZZZ52748Z | BLUE SHIELD (01) | CA |