Individual
SUK SEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MED PLAZA, SUITE 365, 214, LOS ANGELES, CA 90095-0001
(310) 301-8708
(310) 301-8751
Mailing address
9144 GREENDALE CT, ELK GROVE, CA 95758-6454
(916) 683-5996
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A75729
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A757290
MEDICAL PPIN #
CA
Enumeration date
07/20/2006
Last updated
01/12/2022
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