Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeannie Jiwon Su, MD

Individual provider Urology Physician · NPI 1922487800

Jeannie Jiwon Su, MD is an Urology in Santa Monica, California. Qualified in 2015, 11 years ago. Practices with Signature Medical Clinics Inc, a 7-clinician group, works from 2 locations and offers telehealth. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone: (310) 582-7137
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8631 W 3rd St Ste 1115e, Los Angeles, CA 90048-5901 — (310) 278-8330

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence A168007 (CA)

Record details

NPI number1922487800
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 25, 2015
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Signature Medical Clinics Inc — 7 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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