Provider Demographics
NPI:1073687190
Name:WHITE, SUNNY (L AC, OMD, PHD)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:L AC, OMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3616
Mailing Address - Country:US
Mailing Address - Phone:714-745-6260
Mailing Address - Fax:
Practice Address - Street 1:1521 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3616
Practice Address - Country:US
Practice Address - Phone:714-745-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063231171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist