MEDICARE: DANNY SUAZO

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	163W00000X	Registered Nurse	95462034	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1184386401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNY SUAZO

Provider Business Mailing Address
First Line	:	470 E 3RD ST STE A&B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90013-1629
Country	:	US
Telephone Number	:	213-626-6411
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 E 3RD ST STE A&B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90013-1629
Country	:	US
Telephone Number	:	213-626-6411
Fax Number	:

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

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	06/17/2026

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Directions to “ DANNY SUAZO ” Practice Location

Language	Start Address	Practice Location

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