Provider Demographics
NPI:1972757219
Name:HUTCHINSON, SU (MD)
Entity Type:Individual
Prefix:DR
First Name:SU
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUHONG
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1950 SAWTELLE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7072
Practice Address - Country:US
Practice Address - Phone:310-996-9355
Practice Address - Fax:310-231-3016
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002722601Medicare PIN