Provider Demographics
NPI:1063513661
Name:CUA, SEUNG SUE (MD)
Entity type:Individual
Prefix:
First Name:SEUNG SUE
Middle Name:
Last Name:CUA
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 1:1433 W MERCED AVE
Mailing Address - Street 2:STE 114-8
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790
Mailing Address - Country:US
Mailing Address - Phone:626-960-4939
Mailing Address - Fax:626-960-5520
Practice Address - Street 1:1433 W MERCED AVE
Practice Address - Street 2:STE 114-8
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790
Practice Address - Country:US
Practice Address - Phone:626-960-4939
Practice Address - Fax:626-960-5520
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA036509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0013850OtherGROUP MEDI CAL
A36509Medicare ID - Type Unspecified
E01622Medicare UPIN
CAGR0013850OtherGROUP MEDI CAL