Provider Demographics
NPI:1316197932
Name:HODES, SUSAN ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ALICIA
Last Name:HODES
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 1:6 WILLARD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4694
Mailing Address - Country:US
Mailing Address - Phone:949-262-5751
Mailing Address - Fax:
Practice Address - Street 1:6 WILLARD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4694
Practice Address - Country:US
Practice Address - Phone:949-262-5751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine