Individual
DR. SUSAN R CORDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10200 TRINITY PKWY STE 201, STOCKTON, CA 95219-7288
(209) 952-0483
(209) 478-5785
Mailing address
1111 EXPOSITION BLVD BLDG 700, SACRAMENTO, CA 95815-4314
(916) 736-3399
(916) 736-3350
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01043929A
IN
207Y00000X
Otolaryngology Physician
Primary
G129761
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200167750
—
IN
Enumeration date
07/10/2006
Last updated
06/30/2020
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