Healthcare Provider Details

I. General information

NPI: 1376569517
Provider Name (Legal Business Name): SHUICHI SUZUKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 NORTH 1ST AVE. SUITE A
ARCADIA CA
91006
US

IV. Provider business mailing address

8 VERNAL SPG
IRVINE CA
92603-0405
US

V. Phone/Fax

Practice location:
  • Phone: 626-566-2866
  • Fax: 626-566-2850
Mailing address:
  • Phone: 714-943-3788
  • Fax: 949-737-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA72443
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberA72443
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberFTL 41971
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberFTL 41971
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: