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Organization
TIMOTHY P. SUORSA O.D.
Active
Organization
TIMOTHY P. SUORSA O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY P. SUORSA O. D (OWNER)
(559) 784-5127
Entity
Organization
Contact information
Practice address
524 W PUTNAM AVE, PORTERVILLE, CA 93257-3274
(559) 784-5127
Mailing address
524 W PUTNAM AVE, PORTERVILLE, CA 93257-3274
(559) 784-5127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10864T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE4606
RAILROAD MEDICARE
CA
05
—
GSD004930
—
CA
Enumeration date
09/26/2007
Last updated
05/28/2009
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