MEDICARE: J H SUH M D INC

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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1679668701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J H SUH M D INC

Provider Business Mailing Address
First Line	:	639 S NEW HAMPSHIRE AVE
Second Line	:	200
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1342
Country	:	US
Telephone Number	:	213-380-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	639 S NEW HAMPSHIRE AVE
Second Line	:	200
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1342
Country	:	US
Telephone Number	:	213-380-5111
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JIN H SUH
Credential	:	M.D.
Telephone Number	:	213-380-5111

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/25/2007

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