MEDICARE: SUZANNE P. STARLING 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	208000000X	Pediatrics Physician	G149695	CA
2	208000000X	Pediatrics Physician	0101229691	VA
3	2080C0008X	Child Abuse Pediatrics Physician	G149695	CA

General Provider Information

NPI Number	:	1609884907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE P. STARLING M.D.

Provider Business Mailing Address
First Line	:	3020 CHILDRENS WAY # MC5003
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-309-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3665 KEARNY VILLA RD STE 501
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1953
Country	:	US
Telephone Number	:	858-966-5803
Fax Number	:

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/21/2022

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