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1386696185

NPI Code Detail

MEDICARE: SUSAN MAYO M.D.

MEDICARE: SUSAN MAYO M.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
1	207R00000X	Internal Medicine Physician	52330	SC
2	207R00000X	Internal Medicine Physician	2018016629	MO
3	207R00000X	Internal Medicine Physician	4301115586	MI
4	207R00000X	Internal Medicine Physician	R8607	TX
5	207R00000X	Internal Medicine Physician	A63489	CA

General Provider Information

NPI Number	:	1386696185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MAYO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1176
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91358-0176
Country	:	US
Telephone Number	:	805-495-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CALIFORNIA ST STE 2300
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-5424
Country	:	US
Telephone Number	:	800-997-6196
Fax Number	:	833-523-9924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	05/08/2025

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Directions to “ SUSAN MAYO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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