Individual
JEANNIE JIWON SU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 582-7137
Mailing address
1014 BROADWAY # 109, SANTA MONICA, CA 90401-2808
(424) 432-2304
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A168007
CA
Other
Enumeration date
05/25/2015
Last updated
10/28/2025
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