Individual
SUSAN PAYNE ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
G195183
CA
2080P0202X
Pediatric Cardiology Physician
G195183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018632
—
AK
Enumeration date
11/03/2006
Last updated
04/29/2025
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