Provider Demographics
NPI:1588149504
Name:SUZUKI, MAKIKO (AGACNP, FNP)
Entity type:Individual
Prefix:MS
First Name:MAKIKO
Middle Name:
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:AGACNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 LOMITA BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4824
Mailing Address - Country:US
Mailing Address - Phone:310-534-8200
Mailing Address - Fax:310-534-8265
Practice Address - Street 1:3440 LOMITA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4824
Practice Address - Country:US
Practice Address - Phone:310-534-8200
Practice Address - Fax:310-534-8265
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010054363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner