Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A71982 | CA |
NPI | 1033127162 |
---|---|
Provider Name | Dr. Susan Kit-Sum Chu |
First Address | San Diego, CA 92123-2762 |
Second Address | San Diego, CA 92123-2762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A719820 | (05) | CA |
A71982 | (02) | CA |