Active NPI
Michael Ming Ta Su, MD
- Family Medicine Physician
- Los Angeles, CA
National Provider Identifier
1699823534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A91343
- Practice address
- 6041 Cadillac Ave
Los Angeles, CA 90034-1702 - Phone
- (323) 857-2000
- NPI assigned
- Jan 8, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A91343 | CA | Primary |
Addresses
Primary practice location
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Mailing address
393 E Walnut St
3Rd Floor PHR Systems
Pasadena, CA 91188-0001
Phone (000) 000-0000
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1699823534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 E WALNUT ST",
"address_2": "3RD FLOOR PHR SYSTEMS",
"city": "PASADENA",
"state": "CA",
"postal_code": "911880001",
"telephone_number": "000-000-0000",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6041 CADILLAC AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900341702",
"telephone_number": "323-857-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "MICHAEL",
"middle_name": "MING TA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A91343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.