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General NPI Number Information
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NPI Number | 1326100058
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Entity Type | Individual
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Provider Name | BRIAN CHIN-JEN SU M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 320 S GARFIELD AVE SUITE 226
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City | ALHAMBRA
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State | CA
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Zip | 91801-3886
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Country | US
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Telephone | 626-943-9536
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Fax | 626-943-9529
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Provider Business Mailing Address
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Address Line | 320 S GARFIELD AVE SUITE 226
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City | ALHAMBRA
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State | CA
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Zip | 91801-3886
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Country | US
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Telephone | 626-943-9536
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Fax | 626-943-9529
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | G053996
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License Number State | CA
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