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NPI Code Detail

MEDICARE: LANCE SUAN PH.D

MEDICARE: LANCE SUAN PH.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY574HI

General Provider Information

NPI Number : 1124177175
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE SUAN PH.D
Provider Business Mailing Address
First Line : 1700 LANAKILA AVE
Second Line :
City : HONOLULU
State : HI
Zip : 96817-2115
Country : US
Telephone Number : 808-832-3823
Fax Number : 808-832-5850
Provider Business Practice Location Address
First Line : 1700 LANAKILA AVE
Second Line :
City : HONOLULU
State : HI
Zip : 96817-2115
Country : US
Telephone Number : 808-832-3823
Fax Number : 808-832-5850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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Directions to “ LANCE SUAN PH.D” Practice Location

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