Provider Demographics
NPI:1790280592
Name:GASPARIAN, SUZIE ANUSH KAZARYAN (MD)
Entity type:Individual
Prefix:
First Name:SUZIE
Middle Name:ANUSH KAZARYAN
Last Name:GASPARIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9041 MAGNOLIA AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3956
Mailing Address - Country:US
Mailing Address - Phone:951-788-0222
Mailing Address - Fax:951-299-8090
Practice Address - Street 1:9041 MAGNOLIA AVE STE 207
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3956
Practice Address - Country:US
Practice Address - Phone:951-788-0222
Practice Address - Fax:951-299-8090
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5565207W00000X
CAA164468207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology