Provider Demographics
NPI:1679668701
Name:J H SUH M D INC
Entity type:Organization
Organization Name:J H SUH M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-380-5111
Mailing Address - Street 1:639 S NEW HAMPSHIRE AVE
Mailing Address - Street 2:200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1342
Mailing Address - Country:US
Mailing Address - Phone:213-380-5111
Mailing Address - Fax:
Practice Address - Street 1:639 S NEW HAMPSHIRE AVE
Practice Address - Street 2:200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1342
Practice Address - Country:US
Practice Address - Phone:213-380-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG72008Medicare PIN