Healthcare Provider Details

I. General information

NPI: 1841356888
Provider Name (Legal Business Name): KAZUO SUZUKI DPM, CWS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N LA CIENEGA BLVD STE 310
BEVERLY HILLS CA
90211
US

IV. Provider business mailing address

50 N LA CIENEGA BLVD STE 310
BEVERLY HILLS CA
90211-2241
US

V. Phone/Fax

Practice location:
  • Phone: 310-926-1793
  • Fax: 310-289-0142
Mailing address:
  • Phone: 310-926-1793
  • Fax: 310-289-0142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4577
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE4577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: