Provider Demographics
NPI:1942659610
Name:SUAREZ, GEOVANNA (PA-C)
Entity Type:Individual
Prefix:
First Name:GEOVANNA
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 MISSION CENTER CT UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1486
Mailing Address - Country:US
Mailing Address - Phone:520-980-2220
Mailing Address - Fax:
Practice Address - Street 1:780 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1516
Practice Address - Country:US
Practice Address - Phone:650-724-2925
Practice Address - Fax:650-725-3846
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53402363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical