MEDICARE: JIANHUA SU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	19340	CA
2	171100000X	Acupuncturist	AC19340	CA

General Provider Information

NPI Number	:	1447905757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIANHUA SU

Provider Business Mailing Address
First Line	:	1235 S MARY AVE
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-2203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 S MARY AVE
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-2203
Country	:	US
Telephone Number	:	408-507-5358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	07/13/2022

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Directions to “ JIANHUA SU ” Practice Location

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