Provider Demographics
NPI:1659478311
Name:SUN, YA-JIE (LAC, OMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:YA-JIE
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:LAC, OMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 S GARFIELD AVE
Mailing Address - Street 2:#222
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3886
Mailing Address - Country:US
Mailing Address - Phone:626-872-2030
Mailing Address - Fax:888-509-0279
Practice Address - Street 1:320 S GARFIELD AVE
Practice Address - Street 2:#222
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3886
Practice Address - Country:US
Practice Address - Phone:626-872-2030
Practice Address - Fax:888-509-0279
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9386171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC9286OtherACUPUCNTURE LICENSE