Detwiler, Susan P
Detwiler, Susan P is an individual health care provider with primary practice located at 7110 Caminito Pepino , La Jolla CA 92037-5721. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is her primary health care specialty. Detwiler, Susan P can be contacted via phone (858) 539-7300.Contact Information
Primary practice address
7110 Caminito Pepino
La Jolla CA 92037-5721
Phone: (858) 539-7300
Fax: (858) 539-7305
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G75321 | California |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | G75321 | California |
Profile Details
| NPI number | 1184656290 |
|---|---|
| LBN Legal business name | Detwiler, Susan P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Apr 28th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184656290 | NPPES |
| California | MEDICAID | 00G753212 | |
| California | Other | 00G753213 | |
| California | Other | 00G753214 | |
| California | Other | 070017499 | |
| California | MEDICAID | LAB25100F |
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