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General NPI Number Information
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NPI Number | 1558863266
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Entity Type | Organization
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Legal Business Name | ELIZABETH SUH, O.D. LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 4517 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89102-3760
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Country | US
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Telephone | 702-489-5464
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Fax | 702-826-4889
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Provider Business Mailing Address
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Address Line | 949 HUNTINGTON COVE PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89178-2301
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Country | US
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Telephone | 949-433-2512
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Fax | 702-826-4889
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Authorized Official
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Title or Position | O.D.
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Name | DR. ELIZABETH SUH
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Credential | O.D.
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Telephone | 949-433-2512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 802
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License Number State | NV
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