Individual
DR. KENNY C SU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3120 S HACIENDA BLVD, SUITE 103, HACIENDA HEIGHTS, CA 91745-6305
(626) 855-1091
(626) 369-5988
Mailing address
3120 S HACIENDA BLVD, SUITE 103, HACIENDA HEIGHTS, CA 91745-6305
(626) 855-1091
(626) 369-5988
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A43900
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A439000
—
CA
Enumeration date
08/19/2005
Last updated
12/12/2008
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