Provider Demographics
NPI:1073754222
Name:SUZANNE M. QUARDT MD
Entity Type:Organization
Organization Name:SUZANNE M. QUARDT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:QUARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-773-6616
Mailing Address - Street 1:43-585 MONTEREY AVE.
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260
Mailing Address - Country:US
Mailing Address - Phone:760-773-6616
Mailing Address - Fax:760-773-6618
Practice Address - Street 1:43-585 MONTEREY AVE.
Practice Address - Street 2:SUITE 7
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260
Practice Address - Country:US
Practice Address - Phone:760-773-6616
Practice Address - Fax:760-773-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA6353692086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty