Provider Demographics
NPI:1861643264
Name:SUN, HUNG-EN (LAC)
Entity Type:Individual
Prefix:
First Name:HUNG-EN
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ANGELENO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2516
Mailing Address - Country:US
Mailing Address - Phone:626-285-8463
Mailing Address - Fax:626-285-8463
Practice Address - Street 1:5947 KAUFFMAN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2235
Practice Address - Country:US
Practice Address - Phone:626-285-8463
Practice Address - Fax:626-285-8463
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12623171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist