Provider Demographics
NPI:1326100058
Name:SU, BRIAN CHIN-JEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHIN-JEN
Last Name:SU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 S GARFIELD AVE
Mailing Address - Street 2:SUITE 226
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3886
Mailing Address - Country:US
Mailing Address - Phone:626-943-9536
Mailing Address - Fax:626-943-9529
Practice Address - Street 1:320 S GARFIELD AVE
Practice Address - Street 2:SUITE 226
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3886
Practice Address - Country:US
Practice Address - Phone:626-943-9536
Practice Address - Fax:626-943-9529
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG053996207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology