Provider Demographics
NPI:1508183344
Name:CARLOS A. SUESCUN MD LLC
Entity Type:Organization
Organization Name:CARLOS A. SUESCUN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUESCUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-518-0733
Mailing Address - Street 1:7331 E OSBORN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6450
Mailing Address - Country:US
Mailing Address - Phone:480-284-4620
Mailing Address - Fax:480-284-5830
Practice Address - Street 1:7331 E OSBORN RD STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6450
Practice Address - Country:US
Practice Address - Phone:480-284-4620
Practice Address - Fax:480-284-5830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care