Individual
SUSAN LEE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7417 N CEDAR AVE, FRESNO, CA 93720-3637
(559) 500-4502
(559) 573-8749
Mailing address
7417 N CEDAR AVE, FRESNO, CA 93720-3637
(559) 500-4502
(559) 573-8749
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A81958
CA
2086X0206X
Surgical Oncology Physician
A81958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A819580
MEDI-CAL
CA
Enumeration date
12/07/2007
Last updated
12/09/2025
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