Provider Demographics
NPI:1134174493
Name:SUN, CHAO-HUANG (MD, MPH)
Entity type:Individual
Prefix:
First Name:CHAO-HUANG
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 PARK SIERRA DR 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:3660 PARK SIERRA DR
Practice Address - Street 2:SUITE 208
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3071
Practice Address - Country:US
Practice Address - Phone:951-687-2800
Practice Address - Fax:951-687-7290
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40997207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A409970Medicaid
CA00A409972Medicare PIN
CAE50925Medicare UPIN