Doctor Name: | MISS JOHANNA SU |
NPI Number: | 1255547725 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 4301085979 |
Business Practice Address: | 1950 Sunnycrest Drive Suite 2800 Fullerton, CA - 928353618 |
Business Phone Number: | 7149925350 |
Business Fax Number: | 7149928156 |
Mailing Address: | 279 Imperial Hwy, Suite 730 FULLERTON |
State: | CA |
Postal Code: | 928351041 |
Phone Number: | 7144494841 |
Fax Number: | 7144494956 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 04/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 4301085979 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |