Provider Demographics
NPI:1639479694
Name:BIGGLE, SUSAN KUMIKO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KUMIKO
Last Name:BIGGLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2410
Mailing Address - Country:US
Mailing Address - Phone:760-872-8114
Mailing Address - Fax:760-872-3963
Practice Address - Street 1:1190 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2410
Practice Address - Country:US
Practice Address - Phone:760-872-8114
Practice Address - Fax:760-872-3963
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 26930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist