Healthcare Provider Details

I. General information

NPI: 1912476326
Provider Name (Legal Business Name): A R SUZUKI MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JENNER STE 210
IRVINE CA
92618-3844
US

IV. Provider business mailing address

1 JENNER STE 210
IRVINE CA
92618-3844
US

V. Phone/Fax

Practice location:
  • Phone: 714-867-7037
  • Fax: 714-252-7934
Mailing address:
  • Phone: 714-867-7037
  • Fax: 714-252-7934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEJANDRA RUTH SUZUKI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-963-6395