Provider Demographics
NPI:1518962802
Name:FIELD, SUE ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:ALLISON
Last Name:FIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 10069
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-0069
Mailing Address - Country:US
Mailing Address - Phone:909-335-4188
Mailing Address - Fax:
Practice Address - Street 1:2 W FERN AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5916
Practice Address - Country:US
Practice Address - Phone:909-793-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027707207L00000X
CAG127692207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00111299OtherRAILROAD MEDICARE
WA1061696Medicaid
OR022799Medicaid
WAP00111299OtherRAILROAD MEDICARE
WAA52563Medicare UPIN