Provider Demographics
NPI:1699303420
Name:SU, JANET HAEJIN (DO)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:HAEJIN
Last Name:SU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:HAEJIN
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:18 BIG CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2798
Mailing Address - Country:US
Mailing Address - Phone:582-427-1238
Mailing Address - Fax:
Practice Address - Street 1:18 BIG CREEK CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2798
Practice Address - Country:US
Practice Address - Phone:858-242-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.077087207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology