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Individual

DR. SUSAN KAWESKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., F.A.C.S.

Contact information

Practice address
8415 GRANT AVE, LA MESA, CA 91941-5303
(619) 464-9876
(616) 464-9877
Mailing address
8415 GRANT AVE, LA MESA, CA 91941
(619) 464-9876
(619) 464-9877

Taxonomy

Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
G53909
PA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G53909
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1145416243
CA
05
1629076856
CA
Enumeration date
07/12/2005
Last updated
04/04/2018
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