Provider Demographics
NPI:1780730804
Name:BUFFINGTON-SUCEC, SANDRA P (RNP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:P
Last Name:BUFFINGTON-SUCEC
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CATSPAW CPE
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-3222
Mailing Address - Country:US
Mailing Address - Phone:619-429-5855
Mailing Address - Fax:
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 209
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-427-8892
Practice Address - Fax:619-422-7660
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251110363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology