Active NPI
Jason Su, L.AC.
- Acupuncturist
- San Leandro, CA
National Provider Identifier
1972623858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC3487
- Practice address
- 433 Callan Ave
Suite 204
San Leandro, CA 94577-4643 - Phone
- (510) 483-8100
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC3487 | CA | Primary |
Addresses
Primary practice location
433 Callan Ave
Suite 204
San Leandro, CA 94577-4643
Mailing address
1364 Broadway
Alameda, CA 94501-4620
Phone (510) 523-2870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC3487 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972623858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1364 BROADWAY",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014620",
"telephone_number": "510-523-2870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 CALLAN AVE",
"address_2": "SUITE 204",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774643",
"telephone_number": "510-483-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "JASON",
"name_prefix": "Prof.",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC3487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
- Nicole Verdell Strother
- Becky K Stuart, PT, DPT
- Kelsey Stuhr
- Jenna Stymans
- Su Ping Mai DMD Inc
- Zhao Bin Su, D.C., L.AC
- Wendy Suarez
- Subacute Treatment for Adolescent Rehabilitation Services, Inc.
- Subacute Treatment for Adolescent Rehabilitation Services, Inc.
- Subacute Treatment for Adolescent Rehabilitation Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.