Provider Demographics
NPI:1285656447
Name:SU, MICHAEL WEI-CHIH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WEI-CHIH
Last Name:SU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2345 FAIR OAKS BLVD
Mailing Address - Street 2:DEPARTMENT OF DERMATOLOGY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4708
Mailing Address - Country:US
Mailing Address - Phone:916-631-3010
Mailing Address - Fax:
Practice Address - Street 1:2345 FAIR OAKS BLVD
Practice Address - Street 2:DEPARTMENT OF DERMATOLOGY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4708
Practice Address - Country:US
Practice Address - Phone:916-631-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95938207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology