Provider Demographics
NPI:1275778953
Name:SUVAK, JANINE GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JANINE
Middle Name:GAIL
Last Name:SUVAK
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 1:620 NEWPORT CENTER DR STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8011
Mailing Address - Country:US
Mailing Address - Phone:949-718-4424
Mailing Address - Fax:949-721-6650
Practice Address - Street 1:620 NEWPORT CENTER DR STE 1100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8011
Practice Address - Country:US
Practice Address - Phone:949-718-4424
Practice Address - Fax:949-721-6650
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93043208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice