Healthcare Provider Details

I. General information

NPI: 1568546885
Provider Name (Legal Business Name): GEORGE SU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVENUE BLDG. 5, FL. 1, #1M
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVENUE BLDG. 5, FL. 1, #1M
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8335
  • Fax: 628-206-3012
Mailing address:
  • Phone: 628-206-8335
  • Fax: 628-206-3012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA62053
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA62053
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA62053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: