Provider Demographics
NPI:1669623245
Name:CYRIL, SUZANNE LEE (RN, FNP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LEE
Last Name:CYRIL
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:JUNG-AH
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:1403 LOMITA BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2076
Mailing Address - Country:US
Mailing Address - Phone:310-784-5800
Mailing Address - Fax:310-530-9811
Practice Address - Street 1:1403 LOMITA BLVD
Practice Address - Street 2:STE 100
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2076
Practice Address - Country:US
Practice Address - Phone:310-784-5800
Practice Address - Fax:310-530-9811
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA641954163W00000X
CA16705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse