Healthcare Provider Details

I. General information

NPI: 1710953245
Provider Name (Legal Business Name): PATRICK M SUTTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALESSANDRO PL SUITE 420
PASADENA CA
91105-3149
US

IV. Provider business mailing address

50 ALESSANDRO PL SUITE 420
PASADENA CA
91105-3149
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-1710
  • Fax: 626-793-9423
Mailing address:
  • Phone: 626-793-1710
  • Fax: 626-793-9423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberG53929
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: