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General NPI Number Information
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NPI Number | 1598730731
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Entity Type | Individual
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Provider Name | JO ANNE S SUZUKI O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 1111 KENNEDY PL SUITE 1
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City | DAVIS
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State | CA
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Zip | 95616-1266
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Country | US
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Telephone | 530-753-2020
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Fax | 530-753-7441
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Provider Business Mailing Address
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Address Line | 1111 KENNEDY PL SUITE 1
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City | DAVIS
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State | CA
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Zip | 95616-1266
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Country | US
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Telephone | 530-753-2020
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Fax | 530-753-7441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CA09368T
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License Number State | CA
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