Provider Demographics
NPI:1073862090
Name:SUI, CHI-YUAN (LACOMD)
Entity Type:Individual
Prefix:DR
First Name:CHI-YUAN
Middle Name:
Last Name:SUI
Suffix:
Gender:M
Credentials:LACOMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 W 4TH ST APT 309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1100
Mailing Address - Country:US
Mailing Address - Phone:585-506-8624
Mailing Address - Fax:
Practice Address - Street 1:5567 RESEDA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2648
Practice Address - Country:US
Practice Address - Phone:213-387-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14175171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist