Individual provider Active NPI

Gigiyakuan Su, M.D.

  • Family Medicine Physician
  • Antioch, CA
National Provider Identifier
1780692830
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A63427 Issued in CA
Practice address
2335 Country Hills Dr
Antioch, CA 94509-7319
Phone
(925) 608-8500
Fax
(925) 608-8652
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A63427 CA Primary

Addresses

Primary practice location

2335 Country Hills Dr
Antioch, CA 94509-7319

Mailing address

2335 Country Hills Dr
Antioch, CA 94509-7319
Phone (925) 608-8500

Other identifiers 2

IdentifierTypeStateIssuer
00A634270MedicaidCA
P00770145OtherCARAILROAD MEDICARE

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
I20190114002457 CA Order and Referring Only - Family PracticePractitioner - Family Practice 2769531144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63427CAMDPharmacist
A63427CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter North Medical Foundatoin Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1780692830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097319",
            "telephone_number": "925-608-8500",
            "fax_number": "925-608-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097319",
            "telephone_number": "925-608-8500",
            "fax_number": "925-608-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "GIGIYAKUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A634270",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00770145",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.