Provider Demographics
NPI:1497712715
Name:SUN, ADAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:M
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:630 ARBOLADA DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-572-0660
Mailing Address - Fax:626-572-0860
Practice Address - Street 1:500 N GARFIELD AVE
Practice Address - Street 2:STE 306
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-572-0660
Practice Address - Fax:626-572-0860
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC43035207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C430350Medicaid
C43035Medicare ID - Type Unspecified
CA00C430350Medicaid