Provider Demographics
NPI:1013118884
Name:SUN, CHAO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAO
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHAO
Other - Middle Name:
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:770 MASON ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4646
Mailing Address - Country:US
Mailing Address - Phone:707-454-5800
Mailing Address - Fax:707-454-5938
Practice Address - Street 1:5700 STONERIDGE MALL RD STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2872
Practice Address - Country:US
Practice Address - Phone:925-915-9530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1018602083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine