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Individual

DIANE KEIKO SUWABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
123 S SAN MATEO DR, SAN MATEO, CA 94401-3804
(650) 343-4200
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(650) 652-8720

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G64831
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0081923
CA
Enumeration date
11/29/2006
Last updated
06/19/2020
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