Provider Demographics
NPI:1235507740
Name:SARIC-BOSANAC, SUZANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANA
Middle Name:
Last Name:SARIC-BOSANAC
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 1:2951 BENEFIT WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1272
Mailing Address - Country:US
Mailing Address - Phone:916-285-8165
Mailing Address - Fax:
Practice Address - Street 1:2951 BENEFIT WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1272
Practice Address - Country:US
Practice Address - Phone:916-285-8165
Practice Address - Fax:916-285-8175
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA163494207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program