Provider Demographics
NPI:1255445508
Name:MCDIARMID, SUZANNE VALERIE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:VALERIE
Last Name:MCDIARMID
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 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 265
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-825-0867
Practice Address - Fax:310-794-5066
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA391602080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A391600Medicaid
CAGR0053510Medicaid
CAWA39160AMedicare ID - Type Unspecified
CA00A391600Medicaid
CAW11810Medicare ID - Type UnspecifiedGROUP