Provider Demographics
NPI:1346224466
Name:ROSEN, SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:355 ABBOTT ST
Mailing Address - Street 2:100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4483
Mailing Address - Country:US
Mailing Address - Phone:831-751-7070
Mailing Address - Fax:831-751-7050
Practice Address - Street 1:355 ABBOTT ST
Practice Address - Street 2:100
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4483
Practice Address - Country:US
Practice Address - Phone:831-751-7070
Practice Address - Fax:831-751-7050
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA71819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH51673Medicare UPIN