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NPI Code Detail

MEDICARE: DR. SHANNON T SUO M.D.

MEDICARE:  DR. SHANNON T SUO  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
1207Q00000XFamily Medicine PhysicianA69478CA
22084P0800XPsychiatry PhysicianA69478CA

General Provider Information

NPI Number : 1881670438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON T SUO M.D.
Provider Business Mailing Address
First Line : 2365 IRON POINT RD STE 210
Second Line :
City : FOLSOM
State : CA
Zip : 95630-8713
Country : US
Telephone Number : 925-282-1778
Fax Number :
Provider Business Practice Location Address
First Line : 2365 IRON POINT RD STE 210
Second Line :
City : FOLSOM
State : CA
Zip : 95630-8713
Country : US
Telephone Number : 925-282-1778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 11/12/2025

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Directions to “ DR. SHANNON T SUO M.D.” Practice Location

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