Medina, Susan

Medina, Susan is an individual health care provider with primary practice located at 160 S 7Th Ave , La Puente CA 91746-3211. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Other Service Providers / Case Manager/Care Coordinator. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner is her primary health care specialty. Medina, Susan can be contacted via phone (626) 626-4200.

Contact Information

Primary practice address
160 S 7Th Ave La Puente CA 91746-3211
Phone: (626) 626-4200
Fax: (626) 626-4201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1184899379
LBN Legal business name Medina, Susan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2008
Last updated Aug 30th, 2010 - about 14 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 1184899379 NPPES
California Other ICAN803 LA COUNTY DMH STAFF CODE

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