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?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty