MEDICARE: JOON SUH D.O.

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	208M00000X	Hospitalist Physician	18416	CA
2	207R00000X	Internal Medicine Physician	20A18416	CA

General Provider Information

NPI Number	:	1518498674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOON SUH D.O.

Provider Business Mailing Address
First Line	:	1840 VETERAN AVE APT 104
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 VETERAN AVE APT 104
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4579
Country	:	US
Telephone Number	:	949-555-5555
Fax Number	:

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

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	02/01/2026

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Directions to “ JOON SUH D.O.” Practice Location

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