Individual
STANLEY M SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 920-9823
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 920-9823
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
791684
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001438
CA
Other
Enumeration date
07/24/2020
Last updated
12/10/2020
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