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General NPI Number Information
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NPI Number | 1972774131
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Entity Type | Organization
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Legal Business Name | VICTOR R SUCHESKI DPM
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 1110 CORKER STREET
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City | PLACERVILLE
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State | CA
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Zip | 95667
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Country | US
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Telephone | 530-626-5062
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Fax | 530-626-4130
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Provider Business Mailing Address
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Address Line | 1110 CORKER STREET
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City | PLACERVILLE
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State | CA
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Zip | 95667
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Country | US
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Telephone | 530-626-5062
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Fax | 530-626-4130
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Authorized Official
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Title or Position | DPM
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Name | DR. VICTOR R SUCHESKI
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Credential | DPM
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Telephone | 530-626-5062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E27030
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License Number State | CA
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