Provider Demographics
NPI:1992041479
Name:SUN, FEI (L AC)
Entity Type:Individual
Prefix:PROF
First Name:FEI
Middle Name:
Last Name:SUN
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 1:123 E VALLEY BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3599
Mailing Address - Country:US
Mailing Address - Phone:626-288-8845
Mailing Address - Fax:
Practice Address - Street 1:123 E VALLEY BLVD
Practice Address - Street 2:STE 105
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3599
Practice Address - Country:US
Practice Address - Phone:626-288-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4334171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist