Su and Chang Dermatology Associates, Apmc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A94221 Issued in CA

Legal business name

SU AND CHANG DERMATOLOGY ASSOCIATES, APMC

Practice address

3600 N Verdugo Rd
Suite 210
Glendale, CA 91208-1219

Phone

(310) 528-5199

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Thomas T Su, MD, PHDNPI 1346417276

Title

President

Phone

(310) 528-5199

Specialties & licenses 1

Addresses

Other names 1

• Verdugo Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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

• Thomas T. Su, M.D., PH.D.

  • Dermatology Physician
  • Glendale, CA
  • NPI 1346417276
  Medicare reassignment Care Compare group NPD Authorized official
• Yuchi C Chang, M.D.

  • Dermatology Physician
  • Pasadena, CA
  • NPI 1083804439
  Medicare reassignment Care Compare group NPD
• Jane Show Wada, MD

  • Dermatology Physician
  • Montrose, CA
  • NPI 1609862242
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1932547882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911020629",
            "telephone_number": "310-528-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 N VERDUGO RD",
            "address_2": "SUITE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081219",
            "telephone_number": "310-528-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU AND CHANG DERMATOLOGY ASSOCIATES, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-528-5199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A94221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Verdugo Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Yurika Sturdevant
• Anh Su
• Erin H Su
• Tao Su
• Thomas T. Su, M.D., PH.D.
• Jessica Suarez, RBT

• Dermatology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.