Lyndon D Su, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

4301060359 Issued in MI

Practice address

2440 S Sepulveda Blvd
Suite 235
Los Angeles, CA 90064-1784

Phone

(818) 689-1808

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1922180801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 S SEPULVEDA BLVD",
            "address_2": "SUITE 235",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641784",
            "telephone_number": "818-689-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 S SEPULVEDA BLVD",
            "address_2": "SUITE 235",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641784",
            "telephone_number": "818-689-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "LYNDON",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MI",
            "license": "4301060359",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301060359",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G84418",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "G84418",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3483770",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kuo-Shen Su, MD
• Jonathan Su
• Julia Yijia Jaw Su, MD/PHD
• Keng-Chih Su, M.D.
• Lauren Su, MD
• Michael Su, M.D.
• Michael Ming Ta Su, MD
• Steven David Su
• Szu-Wei Su
• Tony C. Su, M.D.

• Dermatopathology (Pathology) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dermatopathology (Pathology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.