Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A140568 | CA |
Y | 111NI0900X | Internist | A140568 | CA |
N | 208D00000X | General Practice Physician | A140568 | CA |
NPI | 1003234063 |
---|---|
Provider Name | Shih-Fan Sun |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Rolling Hills Estates, CA 90274-7606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2014 |
Last Update Date | 09/09/2019 |