Waters, Susan E
Waters, Susan E is an sole proprietor health care provider with primary practice located at 1125 Sir Francis Drake Blvd , Kentfield CA 94904-1418. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Waters, Susan E can be contacted via phone (415) 485-3524.Contact Information
Primary practice address
1125 Sir Francis Drake Blvd
Kentfield CA 94904-1418
Phone: (415) 485-3524
Fax: (415) 485-3507
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G43530 | California |
Profile Details
| NPI number | 1629005772 |
|---|---|
| LBN Legal business name | Waters, Susan E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Oct 23rd, 2008 - about 18 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629005772 | NPPES |
| California | MEDICAID | 00G435300 |
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