Individual provider Active NPI

Young Sun Suh, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1710239223
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C55546 Issued in CA
Practice address
2630 1St Ave
San Diego, CA 92103-6599
Phone
(619) 234-2158
NPI assigned
Oct 8, 2012
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18238 SC
Family Medicine Physician 207Q00000X C55546 CA Primary

Addresses

Primary practice location

2630 1St Ave
San Diego, CA 92103-6599

Mailing address

966 S Western Ave Ste 204
Los Angeles, CA 90006-1015
Phone (323) 735-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20130720000069 CA Practitioner - Family PracticePractitioner - General Practice 9931340742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C55546CAMDFamily Medicine Physician
18238SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego American Indian Health Center CurrentSince Feb 23, 2020 Accepting new patients
Aiken Emergency Physicians PastSince Apr 20, 2025 Accepting new patients

Locations

2602 1st Ave
Ste 105
San Diego, CA 92103

2630 1st Ave
San Diego, CA 92103
Phone (619) 234-2158

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1710239223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061015",
            "telephone_number": "323-735-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-234-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "YOUNG",
        "middle_name": "SUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-08",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18238",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C55546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.