Provider Demographics
NPI:1770783276
Name:SUAREZ, MARCOS ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:ANTONIO
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:39700 BOB HOPE DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3267
Mailing Address - Country:US
Mailing Address - Phone:760-837-8767
Mailing Address - Fax:
Practice Address - Street 1:39700 BOB HOPE DR
Practice Address - Street 2:SUITE 216
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3267
Practice Address - Country:US
Practice Address - Phone:760-837-8767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-353502084P0800X
CAA1169412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry