Active NPI
Joanna C Su, M.D.
- Pediatrics Physician
- Orange, CA
National Provider Identifier
1336179761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A070381
- Practice address
- 331 The City Drive South
Orange, CA 92868 - Phone
- (714) 935-7160
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A070381 | CA | Primary |
Addresses
Primary practice location
331 The City Drive South
Orange, CA 92868
Mailing address
4062 Belvedere St
Irvine, CA 92604-2211
Phone (949) 413-0412
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A070381 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Orange | Past | Accepting new patients |
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.
-
- Prison Health Clinic/Center
- Orange, CA
- NPI 1356147425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336179761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4062 BELVEDERE ST",
"city": "IRVINE",
"state": "CA",
"postal_code": "926042211",
"telephone_number": "949-413-0412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 THE CITY DRIVE SOUTH",
"city": "ORANGE",
"state": "CA",
"postal_code": "92868",
"telephone_number": "714-935-7160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "JOANNA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A070381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.