NPIMap

Individual provider Active NPI

William Myoungwon Suh, MD

  • Cardiovascular Disease Physician
  • Corona, CA
National Provider Identifier
1740200351
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A85060 Issued in CA
Practice address
2250 S Main St Ste 201
Corona, CA 92882-2536
Phone
(951) 621-3232
Fax
(951) 817-6967
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A85060 CA Primary

Addresses

Primary practice location

2250 S Main St Ste 201
Corona, CA 92882-2536

Mailing address

2250 S Main St Ste 201
Corona, CA 92882-2536
Phone (951) 621-3232

Other identifiers 1

IdentifierTypeStateIssuer
00A850600MedicaidCA

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
I20050627000435 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5496790891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Physician Network, IncGroup PAC ID 4880910405, 8 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 201
Corona, CA 92882-2536
Phone (951) 621-3232

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A85060CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altais Medical Group - Riverside, Inc. CurrentSince Feb 1, 2022 Accepting new patients
Southern California Physician Network, Inc Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Modern Nuclear, Inc. CurrentSince Oct 1, 2022 Accepting new patients
The Regents of the University of California Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Jeffrey B Riker MD a Professional Corporation Cardiovascular Disease Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients

Locations

2250 S Main St
Ste 201
Corona, CA 92882
Phone (951) 621-3232

4646 Brockton Ave
Ste 201
Riverside, CA 92506
Phone (951) 585-1800

Organizations & group practices 9

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.

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1740200351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-621-3232",
            "fax_number": "951-817-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-621-3232",
            "fax_number": "951-817-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "WILLIAM",
        "middle_name": "MYOUNGWON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A85060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A850600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.