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

Johanna Su, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1255547725

Johanna Su, MD is an Obstetrics/Gynecology in Fullerton, California. Graduated from Northeastern Ohio University College of Medicine in 2005, 21 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California and Michigan.

Years since qualifying
21
Trained at
Northeastern Ohio University College of Medicine
Licensed in
CA, MI
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

101 Laguna Rd Ste 100
Fullerton, CA 92835-3601
Phone: (714) 992-5350
Fax: (714) 992-8156
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence A 107493 (CA)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 4301085979 (MI)

Record details

NPI number1255547725
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 14, 2007
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021
Mailing address101 Laguna Rd Ste 100, Fullerton, CA 92835-3601

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fullerton