Provider Demographics
NPI:1891818324
Name:SUZAKI, SANDRA (PHARM)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SUZAKI
Suffix:
Gender:F
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2638
Mailing Address - Country:US
Mailing Address - Phone:415-255-3753
Mailing Address - Fax:415-255-3754
Practice Address - Street 1:1380 HOWARD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-255-3753
Practice Address - Fax:415-255-3754
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH48178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1297OtherSFGH INTERNAL USE ONLY
1297OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER