Individual
SUSAN C CISLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3417 VALLE VERDE DR, NAPA, CA 94558-2414
(707) 255-4172
(707) 255-2605
Mailing address
3417 VALLE VERDE DR, NAPA, CA 94558-2414
(707) 255-4172
(707) 255-2605
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A8069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A8069
CA LICENSE
CA
Enumeration date
06/23/2008
Last updated
06/23/2008
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