Provider Demographics
NPI:1265602403
Name:SUN, MINGZHU PEARL (LAC)
Entity type:Individual
Prefix:MRS
First Name:MINGZHU
Middle Name:PEARL
Last Name:SUN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6971 W POTTER DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-9472
Mailing Address - Country:US
Mailing Address - Phone:623-825-9381
Mailing Address - Fax:
Practice Address - Street 1:13540 W CAMINO DEL SOL
Practice Address - Street 2:SUITE 10
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4435
Practice Address - Country:US
Practice Address - Phone:623-556-9686
Practice Address - Fax:623-556-9686
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0027171100000X
CAAC5954171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist