Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20A17504 | CA |
NPI | 1386031201 |
---|---|
Provider Name | Eric Sun |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 21/08/2019 |