Provider Demographics
NPI:1831161645
Name:SUN, EDWARD CHIH-YU (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:CHIH-YU
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 1:359 N SAN MATEO DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2560
Mailing Address - Country:US
Mailing Address - Phone:650-685-7100
Mailing Address - Fax:650-685-7109
Practice Address - Street 1:359 N SAN MATEO DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2560
Practice Address - Country:US
Practice Address - Phone:650-685-7100
Practice Address - Fax:650-685-7109
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64612207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00170606OtherMEDICARE RAILROAD PIN
CAH39333Medicare UPIN
CA00A646120Medicare ID - Type UnspecifiedMEDICARE PPIN