Healthcare Provider Details

I. General information

NPI: 1699605709
Provider Name (Legal Business Name): GRACEFUL SUNRISE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16011 E PRESERVE LOOP
CHINO CA
91708-9718
US

IV. Provider business mailing address

16011 E PRESERVE LOOP
CHINO CA
91708-9718
US

V. Phone/Fax

Practice location:
  • Phone: 840-465-2899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHI TANG
Title or Position: CEO
Credential: MD
Phone: 840-465-2899