MEDICARE: SUSAN E. DOWNEY, MD INC.

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	208200000X	Plastic Surgery Physician	G62700	CA

General Provider Information

NPI Number	:	1770509317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN E. DOWNEY, MD INC.

Provider Business Mailing Address
First Line	:	181 S BUENA VISTA ST FL 3
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4504
Country	:	US
Telephone Number	:	818-748-4930
Fax Number	:	818-748-4928

Provider Business Practice Location Address
First Line	:	181 S BUENA VISTA ST FL 3
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4504
Country	:	US
Telephone Number	:	818-748-4930
Fax Number	:	818-748-4928

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUSAN E. DOWNEY
Credential	:	MD
Telephone Number	:	818-748-4930

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	02/07/2018

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