Individual provider Active NPI

Susan Cho, NP

  • Family Nurse Practitioner
  • Culver City, CA
National Provider Identifier
1104379692
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95006724 Issued in CA
Practice address
3861 Sepulveda Blvd
Culver City, CA 90230-4605
Phone
(310) 450-2191
Fax
(310) 450-0873
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X NP95006724 CA Primary

Addresses

Primary practice location

3861 Sepulveda Blvd
Culver City, CA 90230-4605

Mailing address

3861 Sepulveda Blvd
Culver City, CA 90230-4605
Phone (310) 450-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204001423 CA Practitioner - Nurse Practitioner 6305279449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Health CenterGroup PAC ID 5698667749, 7 clinicians

Practice addresses (Care Compare)

3861 Sepulveda Blvd
Culver City, CA 90230-4605
Phone (310) 450-4772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95006724CAMDFamily Nurse Practitioner

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Westside Family Health Center Multi-Specialty CurrentSince Sep 24, 2019 Accepting new patients
Westside Family Health Center PastSince Aug 30, 2020 Accepting new patients

Locations

3861 Sepulveda Blvd
Culver City, CA 90230
Phone (310) 450-2191

1711 Ocean Park Blvd
Santa Monica, CA 90405
Phone (310) 450-2191

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAHCCA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1104379692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3861 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304605",
            "telephone_number": "310-450-2191",
            "fax_number": "310-450-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304605",
            "telephone_number": "310-450-2191",
            "fax_number": "310-450-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95006724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.