Provider Demographics
NPI:1912716473
Name:SUAREZ, MYLEE (DC)
Entity type:Individual
Prefix:DR
First Name:MYLEE
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32736 GILROY CT
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5616
Mailing Address - Country:US
Mailing Address - Phone:510-505-4568
Mailing Address - Fax:
Practice Address - Street 1:443 ROHNERT PARK EXPY W
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-7907
Practice Address - Country:US
Practice Address - Phone:707-206-9717
Practice Address - Fax:707-206-9509
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor