NPIMap

Individual provider Active NPI

Su Sin Chen, M.D., PH.D.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1720162167
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
C56122 Issued in CA
Practice address
4880 Huntington Dr S
Los Angeles, CA 90032-1945
Phone
(323) 826-7388
Fax
(323) 826-7128
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X C56122 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X C56122 CA
General Practice Physician 208D00000X C56122 CA Primary

Addresses

Primary practice location

4880 Huntington Dr S
Los Angeles, CA 90032-1945

Mailing address

918 N Stoneman Ave Apt D
Alhambra, CA 91801-1428
Phone (713) 409-7310

Other practice location 1

3408 N Eastern Ave
Los Angeles, CA 90032-1934
Phone (713) 409-7310

Other practice location 2

3017 Telegraph Ave Ste 100
Berkeley, CA 94705-2049
Phone (713) 409-7310

Other identifiers 2

IdentifierTypeStateIssuer
194308601MedicaidTX
8U6104OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220304001973 CA Practitioner - General PracticePractitioner - Pathology 2567564701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pathology
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Complete Care Community Health Center, IncGroup PAC ID 3779494190, 45 clinicians

Practice addresses (Care Compare)

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033-3110
Phone (323) 266-6700

4880 Huntington Dr S
Los Angeles, CA 90032-1945
Phone (323) 826-7388

Hospital & facility affiliations

  • Shaid Hospice, Inc. Hospice, Valley Village, CA, CCN B51564
  • Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C56122CAMDGeneral Practice Physician

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Compounding Pharmacy Associates and Consultants Inc CurrentSince Jan 1, 2022 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Oct 29, 2024 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Oct 29, 2024 Accepting new patients
Complete Care Community Health Center, Inc Current Accepting new patients

Locations

3408 N Eastern Ave
Los Angeles, CA 90032
Phone (323) 222-2362

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 266-6700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: su.chen.p1@direct.ccchcenter.nextgenshare.com

Organizations & group practices 14

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

View all 14

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1720162167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 N STONEMAN AVE APT D",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011428",
            "telephone_number": "713-409-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 HUNTINGTON DR S",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900321945",
            "telephone_number": "323-826-7388",
            "fax_number": "323-826-7128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3408 N Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900321934",
            "country_code": "US",
            "telephone_number": "713-409-7310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3017 Telegraph Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052049",
            "country_code": "US",
            "telephone_number": "713-409-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "SU",
        "middle_name": "SIN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-11-22",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "CA",
            "license": "C56122",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C56122",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C56122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194308601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8U6104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.