Suzan Kavusi, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

A127069 Issued in CA

Practice address

650 E Indian School Rd
Phoenix, AZ 85012-1839

Phone

(602) 277-5551

NPI assigned

Apr 30, 2013

Reactivated

Aug 22, 2020

Last updated

Nov 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amarpaul S Sidhu, M. D

  • Specialist
  • Glendora, CA
  • NPI 1538301379
  NPD (past)
• Foothill Dermatology Medical Center

  • Specialist
  • Glendora, CA
  • NPI 1154592368
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1043655301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 FINROD CT",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611817",
            "telephone_number": "650-799-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8403 Fallbrook Ave",
            "address_purpose": "LOCATION",
            "city": "West Hills",
            "state": "CA",
            "postal_code": "913043226",
            "country_code": "US",
            "telephone_number": "818-737-6079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "183 E 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959262341",
            "country_code": "US",
            "telephone_number": "530-891-6244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 Parnassus Ave, Moffitt Room 580",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94143",
            "country_code": "US",
            "telephone_number": "415-443-1623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 E Foothill Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "91740",
            "country_code": "US",
            "telephone_number": "626-852-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVUSI",
        "first_name": "SUZAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "deactivation_date": "2020-08-12",
        "reactivation_date": "2020-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A127069",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A127069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashleen Kaushal
• Lisa Marie Kavanagh, LPC
• Shailee Kavathia, M.D.
• Karen Grace Kavena, NP
• Mahyar Kavian
• Karlee Mariko Wehimakanoe Kawasaki, OD
• Laura J Kawasaki, DNP
• Ruth E Kawasaki, M.C.
• Channing J Kay, BSN, DNP-PMHNP.
• David P. Kay, M.D.

• Dermatopathology (Pathology) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dermatopathology (Pathology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.