Provider Demographics
NPI:1396099800
Name:INADOMI, SUZAN CHEN (OD)
Entity type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:CHEN
Last Name:INADOMI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SUZAN
Other - Middle Name:F
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1237 B ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2915
Mailing Address - Country:US
Mailing Address - Phone:510-886-3937
Mailing Address - Fax:510-886-6304
Practice Address - Street 1:1237 B ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2915
Practice Address - Country:US
Practice Address - Phone:510-886-3937
Practice Address - Fax:510-886-6304
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10302TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist