Provider Demographics
NPI:1114057569
Name:HOROWITZ, SUSAN RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RUTH
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7428 EADS AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5036
Mailing Address - Country:US
Mailing Address - Phone:858-551-8070
Mailing Address - Fax:951-486-4330
Practice Address - Street 1:26520 CACTUS AVE.
Practice Address - Street 2:RIVERSIDE CHILD ASSESSMENT TEAM
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555
Practice Address - Country:US
Practice Address - Phone:951-486-5013
Practice Address - Fax:951-486-4330
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG30610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine