Provider Demographics
NPI:1336341130
Name:SU, MAUREEN AN-PING (M D)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:AN-PING
Last Name:SU
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCSF MEDICAL CENTER CHILDRENS HOSPITAL
Mailing Address - Street 2:505 PARNASSUSS AVE BOX 0110
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-665-5979
Mailing Address - Fax:
Practice Address - Street 1:UCSF MEDICAL CENTER CHILDRENS HOSPITAL
Practice Address - Street 2:505 PARNASSUSS AVE BOX 0110
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0001
Practice Address - Country:US
Practice Address - Phone:415-665-5979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA78456OtherMEDICAL LICENSE