Provider Demographics
NPI:1952722605
Name:SUN, XUEMIN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:XUEMIN
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 DUPONT DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-8887
Mailing Address - Country:US
Mailing Address - Phone:949-542-2622
Mailing Address - Fax:
Practice Address - Street 1:2646 DUPONT DR
Practice Address - Street 2:SUITE 250
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-8887
Practice Address - Country:US
Practice Address - Phone:949-542-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15815171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist