Provider Demographics
NPI:1902833510
Name:DOWNEY, SUSAN E (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:181 S BUENA VISTA ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4504
Mailing Address - Country:US
Mailing Address - Phone:818-748-4930
Mailing Address - Fax:818-748-4928
Practice Address - Street 1:181 S BUENA VISTA ST FL 3
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4504
Practice Address - Country:US
Practice Address - Phone:818-748-4930
Practice Address - Fax:818-748-4928
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG62700208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG62700BMedicare PIN