Provider Demographics
NPI:1235131061
Name:SUN, KARL TSCHA-NING (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:TSCHA-NING
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 CENTER DR
Mailing Address - Street 2:STE 401
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3017
Mailing Address - Country:US
Mailing Address - Phone:760-598-8058
Mailing Address - Fax:760-598-8078
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:STE 401
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-668-1550
Practice Address - Fax:619-668-1554
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68612207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A686120OtherBLUE SHIELD
CA110185464OtherRR MEDICARE
CA00A686120Medicaid
CAWA68612AMedicare PIN
CA00A686120OtherBLUE SHIELD