MEDICARE: DR. SUZANNE PANG

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	183500000X	Pharmacist	28901	CA

General Provider Information

NPI Number	:	1649553421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE PANG

Provider Business Mailing Address
First Line	:	745 CLEMENT ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-2216
Country	:	US
Telephone Number	:	415-668-5250
Fax Number	:	415-668-1438

Provider Business Practice Location Address
First Line	:	745 CLEMENT ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-2216
Country	:	US
Telephone Number	:	415-668-5250
Fax Number	:	415-668-1438

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

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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Directions to “ DR. SUZANNE PANG ” Practice Location

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