Active NPI
Paul Sucgang, D.O.
- Family Medicine Physician
- San Gabriel, CA
National Provider Identifier
1205843711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A9629
- Practice address
- 207 S Santa Anita St Ste G18
San Gabriel, CA 91776-1147 - Phone
- (626) 389-8448
- Fax
- (626) 768-7585
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A9629 | CA | Primary |
Addresses
Primary practice location
207 S Santa Anita St Ste G18
San Gabriel, CA 91776-1147
Mailing address
207 S Santa Anita St Ste G18
San Gabriel, CA 91776-1147
Phone (626) 389-8448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508178930 | Medicaid | CA |
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9629 | CA | MD | Mental Health Counselor |
| 20A9629 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SGV Family Medical Group, Inc | Family Medicine | Current | Accepting new patients |
Locations
416 W Las Tunas Dr
Ste 201
San Gabriel, CA 91776
Phone (626) 289-8598
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Pomona, CA
- NPI 1356906937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749772800000",
"number": "1205843711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 S SANTA ANITA ST STE G18",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917761147",
"telephone_number": "626-389-8448",
"fax_number": "626-768-7585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 S SANTA ANITA ST STE G18",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917761147",
"telephone_number": "626-389-8448",
"fax_number": "626-768-7585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUCGANG",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2025-06-13",
"certification_date": "2025-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A9629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508178930",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.