Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G34109 | CA |
NPI | 1033187133 |
---|---|
Provider Name | Steve Wei-Shing Su |
First Address | Fresno, CA 93720-2989 |
Second Address | Fresno, CA 93720-2989 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 28/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G341090 | (05) | CA |
A89568 | (02) | CA |