Provider Demographics
NPI:1457306698
Name:SUN, WILLIAM LI (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LI
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13555 W MCDOWELL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2624
Mailing Address - Country:US
Mailing Address - Phone:623-535-0740
Mailing Address - Fax:623-535-0741
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2624
Practice Address - Country:US
Practice Address - Phone:623-535-0740
Practice Address - Fax:623-535-0741
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33617207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ912734Medicaid
AZ912734Medicaid