Dr Suehong Tao, MD | |
17083 Main St, Hesperia, CA 92345-6075 | |
(760) 241-6666 | |
(760) 947-5619 |
Full Name | Dr Suehong Tao |
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Gender | Female |
Speciality | Pediatrics |
Location | 17083 Main St, Hesperia, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588639314 | NPI | - | NPPES |
0018489060003 | Medicaid | PA | |
02407312 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD073327L (Pennsylvania) | Secondary |
208000000X | Pediatrics | 222009 (New York) | Secondary |
208000000X | Pediatrics | C150655 (California) | Primary |
Entity Name | Providence Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
---|---|
Dr Suehong Tao, MD 200 W Center Street Promenade, Suite 400, Anaheim, CA 92805-3960 Ph: (714) 449-4800 | Dr Suehong Tao, MD 17083 Main St, Hesperia, CA 92345-6075 Ph: (760) 241-6666 |
Dr. Bryan Andrew Mitton, MD, PHD Pediatrics Medicare: Medicare Enrolled Practice Location: 12021 Jacaranda Ave Ste 101, Hesperia, CA 92345 Phone: 760-956-5057 | |
Dr. Carmelita Antoquia Raymundo-devera, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 16455 Main St., Suite 1, Hesperia, CA 92345 Phone: 760-947-2161 Fax: 760-947-3673 | |
Aparna Sharma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15398 Main St, Ste. B, Hesperia, CA 92345 Phone: 760-949-4118 Fax: 760-949-0987 | |
Dr. Saheb Sahu, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 11919 Hesperia Rd, Hesperia, CA 92345 Phone: 760-948-1454 Fax: 760-948-6100 | |
Mrs. Cheryl Ann Emoto, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16455 Main St, Hesperia, CA 92345 Phone: 760-947-2161 Fax: 760-947-3673 | |
Hanser Beunes Soler, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16455 Main St Ste 1, Hesperia, CA 92345 Phone: 760-947-2161 |