Frederica Nina Su

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FREDERICA NINA SU

Practice address

1000 Newbury Rd Ste 115
Newbury Park, CA 91320-6436

Phone

(805) 375-1611

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Frederica Su, MDNPI 1811417173

Title

MD

Phone

(805) 375-1611

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frederica Nina Su, MD

  • Student in an Organized Health Care Education/Training Program
  • Colton, CA
  • NPI 1811417173
  NPD Authorized official

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1821799891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 115",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206436",
            "telephone_number": "805-375-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 115",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206436",
            "telephone_number": "805-375-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICA NINA SU",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "FREDERICA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "805-375-1611",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.