Individual
BO SUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 S SANTA ANITA ST STE 330, SAN GABRIEL, CA 91776-1154
(626) 458-1888
Mailing address
316 E LAS TUNAS DR, SAN GABRIEL, CA 91776-1535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95004617
CA
Other
Enumeration date
05/14/2017
Last updated
10/01/2018
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