Provider Demographics
NPI:1558882431
Name:FENG, SUNAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNAH
Middle Name:
Last Name:FENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 PROSPECT ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4694
Mailing Address - Country:US
Mailing Address - Phone:858-352-6036
Mailing Address - Fax:
Practice Address - Street 1:302 PROSPECT ST UNIT 4
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4694
Practice Address - Country:US
Practice Address - Phone:858-350-6036
Practice Address - Fax:858-382-0541
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA677492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology