| Monica Su Md Inc | |
|
1000 Newbury Rd Ste 115 Newbury Park CA 91320-6435 | |
| (805) 375-1633 | |
| (805) 955-9966 |
| Full Name | Monica Su Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 1000 Newbury Rd, Newbury Park, California |
| Authorized Official Name and Position | Lisa Ann Vanessen (INSURANCE ADMINISTRATOR) |
| Authorized Official Contact | 8059559990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monica Su Md Inc 1000 Newbury Rd Ste 115 Newbury Park CA 91320-6435 Ph: (805) 375-1633 | Monica Su Md Inc 1000 Newbury Rd Ste 115 Newbury Park CA 91320-6435 Ph: (805) 375-1633 |
| NPI Number | 1881074300 |
|---|---|
| Provider Enumeration Date | 06/01/2015 |
| Last Update Date | 08/31/2015 |
| Medicare PECOS PAC ID | 2062727894 |
|---|---|
| Medicare Enrollment ID | O20150821014424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881074300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A134489 (California) | Primary |
| Provider Name | Monica Su |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396090379 PECOS PAC ID: 3971818709 Enrollment ID: I20150902000409 |
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