Individual
DALE E SUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2320 BATH ST, SUITE 208, SANTA BARBARA, CA 93105-4339
(805) 682-7984
(805) 569-2964
Mailing address
PO BOX 15778, IRVINE, CA 92623-5778
(949) 263-8620
(949) 263-0473
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G58015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G580150
BLUE SHIELD OF CA
CA
05
—
00G580150
—
CA
01
—
P00278492
RR MC
CA
Enumeration date
05/20/2006
Last updated
02/07/2014
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