MEDICARE: DR. GEORGE U SUYAT MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A52106	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A52106	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1023047669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE U SUYAT MD, MPH

Provider Business Mailing Address
First Line	:	2105 BEVERLY BLVD
Second Line	:	SUITE 131
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2216
Country	:	US
Telephone Number	:	213-413-8836
Fax Number	:	213-413-2616

Provider Business Practice Location Address
First Line	:	2105 BEVERLY BLVD
Second Line	:	SUITE 131
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2216
Country	:	US
Telephone Number	:	213-413-8836
Fax Number	:	213-413-2616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/17/2025

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