Individual
DR. SUSAN CHINN AMATURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1002 MENDOCINO AVE, SANTA ROSA, CA 95401-4330
(707) 577-8292
(707) 284-1230
Mailing address
1002 MENDOCINO AVE, SANTA ROSA, CA 95401-4330
(707) 577-8292
(707) 284-1230
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G60552
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G60552
CA
207ND0900X
Dermatopathology Physician
G60552
CA
207NS0135X
Procedural Dermatology Physician
G60552
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FK810A
MEDICARE PROVIDER NUMBER
CA
Enumeration date
07/11/2006
Last updated
08/30/2012
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