Susan T Koo, MD

Primary specialty

Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X

License

A87500 Issued in CA

Practice address

8626 Lower Sacramento Rd Ste 41
Stockton, CA 95210-1835

Phone

(209) 478-2487

NPI assigned

Jun 8, 2017

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1386173698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 STONE EDGE CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792434",
            "telephone_number": "415-672-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8626 LOWER SACRAMENTO RD STE 41",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952101835",
            "telephone_number": "209-478-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "SUSAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "CA",
            "license": "A87500",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "TPME766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Shigeo Komure, O.D.
• Carol Kong, LCSW
• May Kong
• Saorath Kong
• Jajin Koo
• Giana Rose Kooger, LMFT
• Dana Kopping, RD
• Zachary Kor
• Thos Francis Korcz Sr., M.S., M.B.A.
• Chensorieh Thearedasokha Korm Kheandeng

• Anesthesiology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.