Provider Demographics
NPI:1982698478
Name:FELSON, SUZANNE C (DPM)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:C
Last Name:FELSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 N EL CIELO
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-323-8657
Mailing Address - Fax:760-318-9083
Practice Address - Street 1:275 N. EL CIELO
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-323-8657
Practice Address - Fax:760-318-9083
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3731213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00E37310Medicare PIN
CAU12259Medicare UPIN
CA000E37310Medicare ID - Type Unspecified