Provider Demographics
NPI:1710956412
Name:BIEGEL, SUSAN CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CHRISTINE
Last Name:BIEGEL
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 1:1004 W FOOTHILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3774
Mailing Address - Country:US
Mailing Address - Phone:909-985-1908
Mailing Address - Fax:909-963-1800
Practice Address - Street 1:1004 W FOOTHILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3774
Practice Address - Country:US
Practice Address - Phone:909-985-1908
Practice Address - Fax:909-963-1800
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0100350Medicaid
CAGR0100350Medicaid