Susan M Kallal, M.D. Pharm.D., a.M.C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A70271 Issued in CA

Legal business name

SUSAN M KALLAL, M.D. PHARM.D., A.M.C

Practice address

10921 Wilshire Blvd Ste 901
Los Angeles, CA 90024-4000

Phone

(310) 828-1915

Fax

(310) 443-0474

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Susan M Kallal, M.D.NPI 1447312384

Title

Owner

Phone

(310) 828-1915

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Margaret Kallal, MD PHARM D

  • Dermatology Physician
  • Bellingham, WA
  • NPI 1447312384
  NPD (past) Authorized official

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1174705560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 901",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244000",
            "telephone_number": "310-828-1915",
            "fax_number": "310-443-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 901",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244000",
            "telephone_number": "310-828-1915",
            "fax_number": "310-443-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN M KALLAL, M.D. PHARM.D., A.M.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "KALLAL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-828-1915",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A70271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monika Sury, LCSW
• Angela Natali Suryakusuma, DDS
• Susan B Krevoy Eating Disorders Program at Wright Institute
• Susan Choi & Associates Inc
• Susan E Sprau MD a Professional Corporation
• Susan N Fukushima MD Inc
• Susan Pekarovics MD a Professional Corporation
• Susan Quinn
• Susan Schmidt-Lackner a Professional Medical Corporation
• Susana Santiago-Soriano

• Dermatology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.