MEDICARE: DR. MERTON CHIKAO SUZUKI 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	208200000X	Plastic Surgery Physician	G21638	CA

General Provider Information

NPI Number	:	1902916349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERTON CHIKAO SUZUKI M.D.

Provider Business Mailing Address
First Line	:	12630 MONTE VISTA RD
Second Line	:	SUITE 108
City	:	POWAY
State	:	CA
Zip	:	92064-2530
Country	:	US
Telephone Number	:	858-487-6860
Fax Number	:	858-487-4166

Provider Business Practice Location Address
First Line	:	12630 MONTE VISTA RD
Second Line	:	SUITE 108
City	:	POWAY
State	:	CA
Zip	:	92064-2530
Country	:	US
Telephone Number	:	858-487-6860
Fax Number	:	858-487-4166

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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