Provider Demographics
NPI:1730258195
Name:ZAVARO, SUHAIL HANNA (MD)
Entity type:Individual
Prefix:
First Name:SUHAIL
Middle Name:HANNA
Last Name:ZAVARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PIERCE ST
Mailing Address - Street 2:#102
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4124
Mailing Address - Country:US
Mailing Address - Phone:619-668-4700
Mailing Address - Fax:619-668-0049
Practice Address - Street 1:300 S PIERCE ST
Practice Address - Street 2:#102
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4124
Practice Address - Country:US
Practice Address - Phone:619-668-4700
Practice Address - Fax:619-668-0049
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA46162207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46162OtherMEDICAL LICENSE