Suzanne Smith, RD | |
4520 Executive Dr, Suite Plaza 1, San Diego, CA 92121-3018 | |
(619) 543-3133 | |
Not Available |
Full Name | Suzanne Smith |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 4520 Executive Dr, San Diego, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174977870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 996140 (California) | Primary |
Provider Name | Regents Of The University Of California |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1376646869 PECOS PAC ID: 3577476761 Enrollment ID: O20031112000695 |
Provider Name | Regents Of The University Of California |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1225130677 PECOS PAC ID: 3577476761 Enrollment ID: O20031209000783 |
Provider Name | Regents Of The University Of California |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1578672184 PECOS PAC ID: 3577476761 Enrollment ID: O20031211000464 |
Mailing Address | Practice Location Address |
---|---|
Suzanne Smith, RD 4520 Executive Dr, Suite Plaza 1, San Diego, CA 92121-3018 Ph: (844) 377-7678 | Suzanne Smith, RD 4520 Executive Dr, Suite Plaza 1, San Diego, CA 92121-3018 Ph: (619) 543-3133 |
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