Healthcare Provider Details

I. General information

NPI: 1538422407
Provider Name (Legal Business Name): YOKO SUZUKI MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2012
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ODYSSEY
IRVINE CA
92618-3186
US

IV. Provider business mailing address

14642 NEWPORT AVE STE 408
TUSTIN CA
92780-6091
US

V. Phone/Fax

Practice location:
  • Phone: 949-333-2929
  • Fax: 493-333-2679
Mailing address:
  • Phone: 657-218-4022
  • Fax: 657-218-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberA112753
License Number StateCA

VIII. Authorized Official

Name: YOKO SUZUKI
Title or Position: CEO
Credential: M.D
Phone: 949-333-2929