Individual
DR. ANDY K SU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 N TRACY BLVD, TRACY, CA 95376-3451
(209) 832-6018
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A69334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOA693340
BLUE SHIELD
CA
05
—
OOA693340
—
CA
Enumeration date
11/04/2005
Last updated
04/07/2008
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