NPIMap

Individual provider Active NPI

Susanna Isabel Chou, M.D.

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1104889724
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A73158 Issued in CA
Practice address
340 4TH Avenue
Suite 5a
Chula Vista, CA 91910-3813
Phone
(619) 425-5559
Fax
(619) 425-5588
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A73158 CA Primary

Addresses

Primary practice location

340 4TH Avenue
Suite 5a
Chula Vista, CA 91910-3813

Mailing address

374 E H St
Suite a, PMB-105
Chula Vista, CA 91910-7484
Phone (619) 425-5559

Other identifiers 1

IdentifierTypeStateIssuer
00A731580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040212000238 CA Practitioner - Family Practice 6709770456 Reassigns benefits to 1 organization
Practice locations: Chula Vista, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Harvard Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

340 4TH Ave
Suite 12
Chula Vista, CA 91910-3813
Phone (619) 425-5559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A73158CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Feb 25, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: schou80889@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1104889724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 E H ST",
            "address_2": "SUITE A, PMB-105",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107484",
            "telephone_number": "619-425-5559",
            "fax_number": "619-425-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 4TH AVENUE",
            "address_2": "SUITE 5A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-425-5559",
            "fax_number": "619-425-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOU",
        "first_name": "SUSANNA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A73158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A731580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.