Logan, Susan C

Logan, Susan C is an individual health care provider with primary practice located at 1111 Sonoma Avenue Suite 202, Santa Rosa CA 95405. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Logan, Susan C can be contacted via phone (707) 575-1626.

Contact Information

Primary practice address
1111 Sonoma Avenue Suite 202 Santa Rosa CA 95405
Phone: (707) 575-1626
Fax: (707) 575-3941
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G69486 California

Profile Details

NPI number 1982716221
LBN Legal business name Logan, Susan C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jan 29th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982716221 NPPES
California Other P01350003 RAILROAD MEDICARE
California MEDICAID 1982716221 RAILROAD MEDICARE

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