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General NPI Number Information
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NPI Number | 1730238783
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Entity Type | Individual
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Provider Name | SUZANNE J WHITE MD
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 285 MERCEY SPRINGS RD STE D
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City | LOS BANOS
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State | CA
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Zip | 93635-3878
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Country | US
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Telephone | 209-827-1440
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Fax | 209-827-1571
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Provider Business Mailing Address
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Address Line | 2644 M ST STE A
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City | MERCED
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State | CA
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Zip | 95340-2826
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Country | US
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Telephone | 209-827-1440
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Fax | 209-827-1571
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A64192
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License Number State | CA
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