Provider Demographics
NPI:1811090228
Name:SUN, GEORGE KAU-TIN (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:KAU-TIN
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:624 W DUARTE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:626-447-8828
Mailing Address - Fax:626-447-0118
Practice Address - Street 1:624 W DUARTE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007
Practice Address - Country:US
Practice Address - Phone:626-447-8828
Practice Address - Fax:626-447-0118
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG70678207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G70678Medicare UPIN