Michelle Su, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA059532 Issued in PA

Practice address

834 Chestnut St Apt 827
Philadelphia, PA 19107-5140

Phone

(714) 943-0080

NPI assigned

Feb 7, 2011

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

Other names 1

• Michelle Chang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477859577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST APT 827",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075140",
            "telephone_number": "714-943-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST APT 827",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075140",
            "telephone_number": "714-943-0080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11611 San Vicente Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900495106",
            "country_code": "US",
            "telephone_number": "310-820-0013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059532",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "23007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CHANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fang-Yu Su, DMD
• Henry H. Su, D.O.
• Isaac E Su, MD
• Laura Su, MD. PHD.
• Lisa Su, MD
• Simon Yongquan Su, MD
• Stacey Su, MD
• Vinh Su, PHARMD
• Chintana Suanlarm, MD
• Adolfo Suarez, MA

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.