Monica Su MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A134489 Issued in CA

Legal business name

MONICA SU MD INC

Practice address

1000 Newbury Rd
Ste 115
Newbury Park, CA 91320-6435

Phone

(805) 375-1633

Fax

(805) 955-9966

NPI assigned

Jun 1, 2015

Last updated

Aug 31, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Ann Vanessen

Title

Insurance Administrator

Phone

(805) 955-9990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Monica Waidmann, MD

  • Specialist
  • Newbury Park, CA
  • NPI 1396090379
  Medicare reassignment NPD
• Steven Randall Koe, M.D.

  • Internal Medicine Physician
  • Newbury Park, CA
  • NPI 1174517296
  NPD

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1881074300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD",
            "address_2": "STE 115",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206435",
            "telephone_number": "805-375-1633",
            "fax_number": "805-955-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD",
            "address_2": "STE 115",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206435",
            "telephone_number": "805-375-1633",
            "fax_number": "805-955-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONICA SU MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "VANESSEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "805-955-9990"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A134489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryleigh Miller, PA-C
• Milton G. Zweig, DDS, Inc.
• Aram Mkhitarian, D.O.
• Sanaz Mohseni, DDS
• Aliah Monette
• Frances Mora
• Angelica Morales
• Juliet Austin Murray, DC
• Erinn Myers
• National Sleep Services, LLC

• General Practice Physician in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.