# SU SALUD MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104476217
- **Authorized official:** ABDEL N ABDELSAYED MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (323) 918-2700

## Contact information

- **Practice address:** 7418 STATE ST, HUNTINGTON PARK, CA 90255-5928
- **Practice address phone:** (323) 835-6298
- **Practice address fax:** (323) 835-6081
- **Mailing address:** 7418 STATE ST, HUNTINGTON PARK, CA 90255-5928
- **Mailing address phone:** (323) 835-6298
- **Mailing address fax:** (323) 835-6081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/19/2019
- **Last updated:** 05/01/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1922164961 | — | CA |