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Individual
MS. SUSAN ELAINE O'MALLEY
Active
Individual
MS. SUSAN ELAINE O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12011
CA
363L00000X
Nurse Practitioner
260226
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PA120110
RAILROAD MEDICARE
CA
Enumeration date
04/26/2006
Last updated
11/05/2007
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