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General NPI Number Information
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NPI Number | 1790280592
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Entity Type | Individual
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Provider Name | SUZIE ANUSH KAZARYAN GASPARIAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 9041 MAGNOLIA AVE STE 207
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City | RIVERSIDE
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State | CA
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Zip | 92503-3956
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Country | US
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Telephone | 951-788-0222
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Fax | 951-299-8090
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Provider Business Mailing Address
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Address Line | 9041 MAGNOLIA AVE STE 207
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City | RIVERSIDE
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State | CA
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Zip | 92503-3956
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Country | US
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Telephone | 951-788-0222
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Fax | 951-299-8090
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | T5565
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | A164468
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A164468
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License Number State | CA
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