Provider Demographics
NPI:1902690456
Name:SUZUKI, KEITA
Entity type:Individual
Prefix:
First Name:KEITA
Middle Name:
Last Name:SUZUKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 S GARFIELD AVE UNIT 219
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-6881
Mailing Address - Country:US
Mailing Address - Phone:626-316-3668
Mailing Address - Fax:
Practice Address - Street 1:800 N FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-7264
Practice Address - Country:US
Practice Address - Phone:626-316-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist