Active NPI
Jonah Su
- Pharmacist
- Covina, CA
National Provider Identifier
1316553894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83118
- Practice address
- 1433 N Hollenbeck Ave Ste 103
Covina, CA 91722-1558 - Phone
- (626) 251-1640
- NPI assigned
- Sep 19, 2020
- Last updated
- May 18, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83118 | CA | Primary |
Addresses
Primary practice location
1433 N Hollenbeck Ave Ste 103
Covina, CA 91722-1558
Mailing address
1433 N Hollenbeck Ave Ste 103
Covina, CA 91722-1558
Phone (626) 251-1640
Other practice location 1
2260 University Dr
Newport Beach, CA 92660-3319
Phone (877) 374-5162
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jonah.su@cchealth.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83118 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Devani Investments 2 LLC | Current | Accepting new patients | |
| Covina Healthcare Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Assisted Living Facility
- Murrieta, CA
- NPI 1245182047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1316553894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1433 N HOLLENBECK AVE STE 103",
"city": "COVINA",
"state": "CA",
"postal_code": "917221558",
"telephone_number": "626-251-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 N HOLLENBECK AVE STE 103",
"city": "COVINA",
"state": "CA",
"postal_code": "917221558",
"telephone_number": "626-251-1640"
}
],
"practiceLocations": [
{
"address_1": "2260 University Dr",
"address_purpose": "LOCATION",
"city": "Newport Beach",
"state": "CA",
"postal_code": "926603319",
"country_code": "US",
"telephone_number": "877-374-5162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SU",
"first_name": "JONAH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-19",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83118",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jonah.su@cchealth.com",
"affiliation": "N",
"address_1": "52 Stagecoach",
"city": "Irvine",
"state": "CA",
"country_code": "US",
"postal_code": "926020203",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.