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Individual
DR. TIMOTHY PAUL SUORSA
Active
Individual
DR. TIMOTHY PAUL SUORSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10864T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5664210001
MEDICARE NSC
CA
05
—
GSD004930
—
CA
01
—
P00294171
RAILROAD MEDICARE
CA
Enumeration date
11/06/2006
Last updated
05/27/2009
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