Chad Sudoko

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

A202425 Issued in CA

Practice address

1201 W la Veta Ave
Orange, CA 92868-4203

Phone

(714) 509-7094

Fax

(714) 953-5462

NPI assigned

Apr 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Children's Surgical Associates LTD

  • Plastic Surgery Physician
  • Philadelphia, PA
  • NPI 1326117185
  Medicare reassignment NPD
• Mount Nittany Medical Center Health Services Inc

  dba Mount Nittany Physician Group

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554

  Otolaryngology

  Medicare reassignment NPD
• Children's Surgical Associates LTD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Philadelphia, PA
  • NPI 1598834343
  NPD
• Children's Surgical Associates LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Philadelphia, PA
  • NPI 1730268079
  NPD
• Pediatric Subspecialty Faculty, Inc.

  • Pediatrics Physician
  • Orange, CA
  • NPI 1790850279
  NPD (past)

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1366949091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-7094",
            "fax_number": "714-953-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-7094",
            "fax_number": "714-953-5462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-3440",
            "fax_number": "267-425-9552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDOKO",
        "first_name": "CHAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD475150",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CA",
            "license": "A202425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Russell Suba
• Mohammad Subeh, MD
• Sudhakar Subramani, MD
• Jeffrey Suchard, MD
• Gabriel Sudario
• Justin M Sugamura
• Caitlin Suggs, LMFT
• Suzanne Sugiarto, DDS
• Hanae Sugiura, MS
• Haley Gena Suh

• Pediatric Otolaryngology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.