Provider Demographics
NPI:1558352583
Name:SUN, JENNIFER CHIA JUNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHIA JUNE
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:689 W FOOTHILL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3400
Mailing Address - Country:US
Mailing Address - Phone:909-482-2058
Mailing Address - Fax:909-482-2082
Practice Address - Street 1:689 W FOOTHILL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3400
Practice Address - Country:US
Practice Address - Phone:909-482-2058
Practice Address - Fax:909-482-2082
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA85118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85118OtherMEDICAL LICENSE
CABS8570891OtherDEA
CAI10911Medicare UPIN