Individual
SUSAN RADOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3910 VISTA WAY STE 106, OCEANSIDE, CA 92056-4513
(760) 941-2000
Mailing address
5080 SPECTRUM DR STE 1200W, ADDISON, TX 75001-4624
(661) 678-2300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
19822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189749801
—
TX
01
—
8Y1603
BCBS
TX
Enumeration date
12/28/2006
Last updated
06/07/2022
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