Provider Demographics
NPI:1174685770
Name:LI, SUZANNE G (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:G
Last Name:LI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2100 WEBSTER ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2375
Mailing Address - Country:US
Mailing Address - Phone:415-923-3030
Mailing Address - Fax:415-673-7957
Practice Address - Street 1:2100 WEBSTER ST STE 212
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2375
Practice Address - Country:US
Practice Address - Phone:415-923-3030
Practice Address - Fax:415-673-7957
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2024-07-26
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Provider Licenses
StateLicense IDTaxonomies
CAG425460207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G425460Medicaid
A89760Medicare UPIN
CAAL1241857OtherDEA