Provider Demographics
NPI:1801159801
Name:SUN, ROBERT B (OD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:SUN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:14405 W COLFAX AVE
Mailing Address - Street 2:#310
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3247
Mailing Address - Country:US
Mailing Address - Phone:303-215-0376
Mailing Address - Fax:303-302-6906
Practice Address - Street 1:7700 W ARROWHEAD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8616
Practice Address - Country:US
Practice Address - Phone:623-486-2121
Practice Address - Fax:623-486-1145
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist