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General NPI Number Information
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NPI Number | 1063690782
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Entity Type | Individual
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Provider Name | BRIAN SU MD
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Gender | Male
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 2 BON AIR RD SUITE 120
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City | LARKSPUR
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State | CA
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Zip | 94939-1141
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Country | US
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Telephone | 415-925-8200
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Fax | 415-464-5480
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Provider Business Mailing Address
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Address Line | 2 BON AIR RD SUITE 120
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City | LARKSPUR
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State | CA
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Zip | 94939-1141
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Country | US
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Telephone | 415-925-8200
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Fax | 415-464-5480
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 237395
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A109113
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License Number State | CA
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