Park, Susanna S.

Park, Susanna S. is an individual health care provider with primary practice located at 4860 Y St Suite 2400, Sacramento CA 95817-2307. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Park, Susanna S. can be contacted via phone (916) 734-6544.

Contact Information

Primary practice address
4860 Y St Suite 2400 Sacramento CA 95817-2307
Phone: (916) 734-6544
Fax: (916) 734-6197
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G75691 California

Profile Details

NPI number 1902881972
LBN Legal business name Park, Susanna S.
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jul 13th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902881972 NPPES
California MEDICAID GR002104I

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