Wickum, Suzanne
Wickum, Suzanne is an individual health care provider with primary practice located at 5901 E 7Th St , Long Beach CA 90822-5201. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Wickum, Suzanne can be contacted via phone (562) 826-8000.Contact Information
Primary practice address
5901 E 7Th St
Long Beach CA 90822-5201
Phone: (562) 826-8000
Fax: (562) 826-5063
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10639TPA | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5166TG | Texas |
Profile Details
| NPI number | 1386648731 |
|---|---|
| LBN Legal business name | Wickum, Suzanne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Dec 6th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386648731 | NPPES |
| Texas | MEDICAID | 040970801 |
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