Provider Demographics
NPI:1215289848
Name:STEVEN H SUCHMAN MD INC
Entity type:Organization
Organization Name:STEVEN H SUCHMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-379-9976
Mailing Address - Street 1:77 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1011
Mailing Address - Country:US
Mailing Address - Phone:805-379-9976
Mailing Address - Fax:805-379-9975
Practice Address - Street 1:77 ROLLING OAKS DR
Practice Address - Street 2:SUITE 305
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1011
Practice Address - Country:US
Practice Address - Phone:805-379-9976
Practice Address - Fax:805-379-9975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215289848Medicare PIN