Active NPI
Min Kyo Suh
- Peer Specialist
- Buena Park, CA
National Provider Identifier
1558612655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-IVDQFO
- Practice address
- 5850 Burnham Ave
Buena Park, CA 90621-1820 - Phone
- (714) 290-8370
- NPI assigned
- Sep 28, 2012
- Last updated
- Dec 18, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-IVDQFO | CA | Primary |
Addresses
Primary practice location
5850 Burnham Ave
Buena Park, CA 90621-1820
Mailing address
5850 Burnham Ave
Buena Park, CA 90621-1820
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 |
|---|---|---|---|
| MPSS-IVDQFO | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1558612655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 BURNHAM AVE",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 BURNHAM AVE",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211820",
"telephone_number": "714-290-8370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUH",
"first_name": "MIN",
"middle_name": "KYO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-28",
"last_updated": "2023-12-18",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-IVDQFO",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buena Park, CA
- Starbright Hospice, Inc.
- Stephen W Smith Chiropractic Inc (Smith Chiropractic of Buena Park)
- Stephen W. Smith Chiropractic
- Renee Flournoy Stokman, LMFT
- Edward S. Suh, D.M.D.
- Sun Kim Medical Corporation
- Justin Sun, OPT
- Sung Hyun Kim, M.D. a Medical Corporation
- Esther Sung, MSN, FNP-C
- Jin Ho Sung, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.