Basic Information
| Provider Information | |||||||||
| NPI: | 1306929823 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUCHARD | ||||||||
| FirstName: | JEFFREY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | EMERGENCY MEDICINE FACULTY GRP | ||||||||
| Address2: | PO BOX 513266 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900513266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144562986 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | UCI MEDICAL CENTER | ||||||||
| Address2: | 101 THE CITY DRIVE SOUTH | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144562986 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2006 | ||||||||
| LastUpdateDate: | 12/14/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 000000G85380 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.