Healthcare Provider Details

I. General information

NPI: 1144268202
Provider Name (Legal Business Name): MARY CHRISTINE SUAREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 SAMARITAN DR 810
SAN JOSE CA
95124-4100
US

IV. Provider business mailing address

2577 SAMARITAN DR 810
SAN JOSE CA
95124-4100
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-1888
  • Fax: 408-356-0877
Mailing address:
  • Phone: 408-358-1888
  • Fax: 408-356-0877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG65698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: