Provider Demographics
NPI:1407159254
Name:SUN, ZHISHENG (OMD LAC)
Entity Type:Individual
Prefix:
First Name:ZHISHENG
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:OMD LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12175 SARATOGA SUNNYVALE RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070
Mailing Address - Country:US
Mailing Address - Phone:408-839-3907
Mailing Address - Fax:
Practice Address - Street 1:12175 SARATOGA SUNNYVALE RD.
Practice Address - Street 2:SUITE A
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070
Practice Address - Country:US
Practice Address - Phone:408-839-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13141171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist