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General NPI Number Information
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NPI Number | 1972749372
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Entity Type | Organization
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Legal Business Name | MERTON SUZUKI MD INC
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 12630 MONTE VISTA RD SUITE 108
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City | POWAY
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State | CA
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Zip | 92064-2530
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Country | US
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Telephone | 858-487-6860
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Fax | 858-487-4166
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Provider Business Mailing Address
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Address Line | 12630 MONTE VISTA RD STE 108
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City | POWAY
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State | CA
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Zip | 92064-2526
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Country | US
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Telephone | 858-487-6860
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Fax | 858-487-4166
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MERTON SUZUKI
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Credential | MD
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Telephone | 858-487-6860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | G21638
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License Number State | CA
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