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Individual
JEFFREY SU
Active
Individual
JEFFREY SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT294376
CA
225100000X
Physical Therapist
294376
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT294376
PHYSICAL THERAPY
CA
Enumeration date
04/30/2018
Last updated
12/10/2020
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