Individual provider Active NPI

Eric Clay Suwyn

  • Independent Duty Medical Technicians
  • Los Angeles, CA
National Provider Identifier
1336350396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
5051 Rodeo Rd
Los Angeles, CA 90016-4790
Phone
(323) 292-2202
Fax
(323) 292-2552
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

5051 Rodeo Rd
Los Angeles, CA 90016-4790

Mailing address

15530 W Mauna Loa LN
Surprise, AZ 85379-6278
Phone (805) 302-9955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336350396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15530 W MAUNA LOA LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796278",
            "telephone_number": "805-302-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 RODEO RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164790",
            "telephone_number": "323-292-2202",
            "fax_number": "323-292-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUWYN",
        "first_name": "ERIC",
        "middle_name": "CLAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.