Provider Demographics
NPI:1003902511
Name:SUAREZ, ZORAIDA I (MD)
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:I
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5363 BALBOA BLVD
Mailing Address - Street 2:STE 433
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316
Mailing Address - Country:US
Mailing Address - Phone:818-788-8838
Mailing Address - Fax:818-788-0851
Practice Address - Street 1:5363 BALBOA BLVD
Practice Address - Street 2:STE 433
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:818-788-8838
Practice Address - Fax:818-788-0851
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42275207R00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200504600OtherDPT OF LABOR
CA00A422750Medicaid
CAZZZ52748ZOtherBLUE SHIELD
CA00A422750Medicaid
CADV745ZMedicare Oscar/Certification