Provider Demographics
NPI:1578769485
Name:ONE, PETER SUN (L,AC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:SUN
Last Name:ONE
Suffix:
Gender:M
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6693 DOWNEY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2822
Mailing Address - Country:US
Mailing Address - Phone:562-634-3300
Mailing Address - Fax:562-634-3313
Practice Address - Street 1:6693 DOWNEY AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2822
Practice Address - Country:US
Practice Address - Phone:562-634-3300
Practice Address - Fax:562-634-3313
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist