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NPI Code Detail

MEDICARE: MRS. SUSAN SALZWEDEL PA-C

MEDICARE: MRS. SUSAN SALZWEDEL PA-C
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
1207Q00000XFamily Medicine PhysicianPA14060CA
2363L00000XNurse PractitionerNP014060CA
3363AS0400XSurgical Physician AssistantPA14060CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP014060OTHERCAMEDICAL LICENSE
213578042OTHERCAQH

General Provider Information

NPI Number : 1891822045
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN SALZWEDEL PA-C
Provider Business Mailing Address
First Line : PO BOX 845996
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-5996
Country : US
Telephone Number : 858-888-7700
Fax Number : 858-221-5014
Provider Business Practice Location Address
First Line : 5522 SEPULVEDA BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91411-3437
Country : US
Telephone Number : 818-990-5020
Fax Number : 818-990-8549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 03/07/2023

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