Individual
SUSAN E. DUTHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Mailing address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G61247
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
G61247
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G612470
BLUE SHIELD OF CA
CA
05
—
00G612470
—
CA
Enumeration date
07/04/2006
Last updated
12/05/2007
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