Provider Demographics
NPI:1538422407
Name:YOKO SUZUKI MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:YOKO SUZUKI MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOKO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUZUKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-333-2929
Mailing Address - Street 1:14642 NEWPORT AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6091
Mailing Address - Country:US
Mailing Address - Phone:657-218-4022
Mailing Address - Fax:657-218-4023
Practice Address - Street 1:22 ODYSSEY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3186
Practice Address - Country:US
Practice Address - Phone:949-333-2929
Practice Address - Fax:493-333-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-16
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112753305R00000X
207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty