Susan Roberts

NPI 1285909556 · on the registry since 2012 · sole proprietor

Practice

Address: 13463 Washington Blvd
Marina Del Rey, CA 90292
Phone: (310) 754-2002
Fax: (310) 754-2010
Organisation at this address: Costco Wholesale Corporation
Costco Wholesale Corporation
Costco Wholesale Corporation
Douglas J Nishida, Od, A Professional Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 183500000X
183500000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-03-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California