Provider Demographics
NPI:1740380286
Name:MICHAEL J SUVAL
Entity Type:Organization
Organization Name:MICHAEL J SUVAL
Other - Org Name:PAJARO VALLEY PERSONAL HEALTHCARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:831-761-7766
Mailing Address - Street 1:1041 FREEDOM BLVD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3263
Mailing Address - Country:US
Mailing Address - Phone:831-761-7766
Mailing Address - Fax:831-761-7769
Practice Address - Street 1:1041 FREEDOM BLVD
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3263
Practice Address - Country:US
Practice Address - Phone:831-761-7766
Practice Address - Fax:831-761-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A63300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN