Healthcare Provider Details

I. General information

NPI: 1346165362
Provider Name (Legal Business Name): DR. SUSAN LEE POWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 E 17TH ST STE F
COSTA MESA CA
92627-4748
US

IV. Provider business mailing address

427 E 17TH ST STE F
COSTA MESA CA
92627-4748
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-6245
  • Fax:
Mailing address:
  • Phone: 949-645-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG44004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: