Healthcare Provider Details

I. General information

NPI: 1902833510
Provider Name (Legal Business Name): SUSAN E. DOWNEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 S BUENA VISTA ST FL 3
BURBANK CA
91505-4504
US

IV. Provider business mailing address

181 S BUENA VISTA ST FL 3
BURBANK CA
91505-4504
US

V. Phone/Fax

Practice location:
  • Phone: 818-748-4930
  • Fax: 818-748-4928
Mailing address:
  • Phone: 818-748-4930
  • Fax: 818-748-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG62700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: