Kathryn Suslov, MD

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

130391 Issued in CA

Practice address

893 Sir Francis Drake Blvd
Therapeutic Bodywork Center
San Anselmo, CA 94960-1916

Phone

(415) 723-6555

NPI assigned

Oct 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1224892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1285887901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 SIR FRANCIS DRAKE BLVD",
            "address_2": "THERAPEUTIC BODYWORK CENTER",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601916",
            "telephone_number": "415-723-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 SIR FRANCIS DRAKE BLVD",
            "address_2": "THERAPEUTIC BODYWORK CENTER",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601916",
            "telephone_number": "415-723-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSLOV",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-25",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NY",
            "license": "248038",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "130391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Marie Stansell
• Stephanie Morris
• R Scott Sullender, PHD
• Peijie Sun, PHARMD
• Sunglass City Inc (Wink Optics)
• Jeffrey Thomas Szilagyi, CA L.AC.
• Beth Cooper Tabakin, PH.D.
• Lonnie Tanenberg
• Brook Tarrant
• Steven William Thompson, MPT, OCS, CSCS

• Public Health & General Preventive Medicine Physician in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.