Provider Demographics
NPI:1598890212
Name:KAREFA-JOHNSON, SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:KAREFA-JOHNSON
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 1:255 N EL CIELO RD STE C300
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6992
Mailing Address - Country:US
Mailing Address - Phone:760-674-3344
Mailing Address - Fax:760-674-3372
Practice Address - Street 1:255 N EL CIELO RD STE C300
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6992
Practice Address - Country:US
Practice Address - Phone:760-674-3344
Practice Address - Fax:760-674-3372
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117784207Q00000X
CAG57792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE20150Medicare UPIN