Individual
DR. MICHAEL J SUVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1595 SOQUEL DR STE 400, SANTA CRUZ, CA 95065-1724
(831) 475-1111
(831) 476-5020
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A6330
CA
208M00000X
Hospitalist Physician
Primary
20A6330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX63300
—
CA
Enumeration date
09/24/2006
Last updated
10/04/2017
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