MEDICARE: RAYMOND SUAREZ

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	225100000X	Physical Therapist	295375	CA

General Provider Information

NPI Number	:	1568192326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND SUAREZ

Provider Business Mailing Address
First Line	:	3624 BASSETT CT
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-5202
Country	:	US
Telephone Number	:	650-892-8757
Fax Number	:

Provider Business Practice Location Address
First Line	:	3624 BASSETT CT
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-5202
Country	:	US
Telephone Number	:	650-892-8757
Fax Number	:

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

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	06/14/2022

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Directions to “ RAYMOND SUAREZ ” Practice Location

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