Provider Demographics
NPI:1932535879
Name:SUGIURA, TUONG-THUY MAI (DO)
Entity type:Individual
Prefix:
First Name:TUONG-THUY
Middle Name:MAI
Last Name:SUGIURA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TUONG-THUY
Other - Middle Name:THI
Other - Last Name:MAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:725 HILMA DR
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-6621
Mailing Address - Country:US
Mailing Address - Phone:619-944-0511
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:619-944-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16307207L00000X
NYP94179207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology