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General NPI Number Information
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NPI Number | 1609148162
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Entity Type | Organization
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Legal Business Name | WILBUR SUESBERRY MD INC A MEDICAL CORP
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 1205 GARCES HWY SUITE 207
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City | DELANO
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State | CA
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Zip | 93215-3639
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Country | US
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Telephone | 661-721-1422
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Fax | 661-721-2738
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Provider Business Mailing Address
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Address Line | 1205 GARCES HWY SUITE 207
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City | DELANO
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State | CA
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Zip | 93215-3639
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Country | US
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Telephone | 661-721-1422
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Fax | 661-721-2738
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Authorized Official
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Title or Position | CEO
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Name | WILBUR SUESBERRY
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Credential | MD
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Telephone | 661-721-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | C29033
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License Number State | CA
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