Provider Demographics
NPI: | 1609328129 |
---|---|
Name: | SUN HEALTHCARE AND SURGERY GROUP INC |
Entity Type: | Organization |
Organization Name: | SUN HEALTHCARE AND SURGERY GROUP INC |
Other - Org Name: | XINGBO P SUN |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | XINGBO |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | SUN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPM |
Authorized Official - Phone: | 626-434-9194 |
Mailing Address - Street 1: | 1815 ARNOLD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | MARTINEZ |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94553-4219 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-265-6433 |
Mailing Address - Fax: | 866-735-9266 |
Practice Address - Street 1: | 3700 SUNSET LN STE 1 |
Practice Address - Street 2: | |
Practice Address - City: | ANTIOCH |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94509-6123 |
Practice Address - Country: | US |
Practice Address - Phone: | 925-979-8313 |
Practice Address - Fax: | 025-954-6959 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-11-01 |
Last Update Date: | 2023-11-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty |