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

Piseth Suor, PA

Individual provider Physician Assistant · NPI 1699054809

Piseth Suor, PA is a Physician Assistant in Stockton, California. Graduated from University of California, Davis School of Medicine in 2004, 22 years ago. Practices with Westlane Medical Clinic Inc, a 3-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Trained at
University of California, Davis School of Medicine
Licensed in
CA
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4873 W Ln Ste A
Stockton, CA 95210-4548
Phone: (209) 472-1515
Fax: (209) 472-1651
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 17756 (CA)

Record details

NPI number1699054809
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 5, 2011
Last updated in NPPESAugust 5, 2011

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Westlane Medical Clinic Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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