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Organization

A SUN MEDICAL CLINIC CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW S. SUN M.D. (PROVIDER/OWNER)
(626) 308-0660
Entity
Organization

Contact information

Practice address
288 S SAN GABRIEL BLVD, SUITE 206, SAN GABRIEL, CA 91776-1668
(626) 308-0660
Mailing address
288 S SAN GABRIEL BLVD, SUITE 206, SAN GABRIEL, CA 91776-1668
(626) 308-0660

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G13537
CA
208000000X
Pediatrics Physician
G13537
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G135370
CA
01
G13537
STATE LICENSE
CA
Enumeration date
04/19/2007
Last updated
08/01/2011
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