Susan P Detwiler MD Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

G75321 Issued in CA

Legal business name

SUSAN P DETWILER MD INC

Practice address

7110 Caminito Pepino
La Jolla, CA 92037-5721

Phone

(858) 539-7300

Fax

(858) 539-7305

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Susan P Detwiler, MDNPI 1184656290

Title

President

Phone

(858) 539-7300

Specialties & licenses 1

Addresses

Tax ID family

Susan P Detwiler MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Susan P Detwiler MD Inc

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1487687414
  NPD tax ID

Practitioners 1

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

• Susan P Detwiler, MD

  • Dermatopathology Physician
  • La Jolla, CA
  • NPI 1184656290
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1962611350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7076 CAMINITO VALVERDE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375723",
            "telephone_number": "858-539-7300",
            "fax_number": "858-539-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 CAMINITO PEPINO",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375721",
            "telephone_number": "858-539-7300",
            "fax_number": "858-539-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN P DETWILER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "DETWILER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-539-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "G75321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wynnshang Chen Sun, MD
• Sunil Bhoyrul MD Incorporated
• Surgical Associates of la Jolla Medical Group, Inc.
• Dalga David Surofchy, PHARM.D
• Susan P Detwiler MD Inc
• Pallavi Suvarna
• Julie Anna Suyama, M.D., PH.D.
• Alla F Sverdlik, MD
• Judith Lea Swain, MD
• Matthew James Swan, PA

• Clinical Medical Laboratory in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.