Healthcare Provider Details

I. General information

NPI: 1639013915
Provider Name (Legal Business Name): RADIANT SUN MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19722 MACARTHUR BLVD STE 110
IRVINE CA
92612-2404
US

IV. Provider business mailing address

19722 MACARTHUR BLVD STE 110
IRVINE CA
92612-2404
US

V. Phone/Fax

Practice location:
  • Phone: 949-535-2322
  • Fax: 949-535-2330
Mailing address:
  • Phone: 949-326-7060
  • Fax: 949-326-7049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE MATT
Title or Position: OWNER
Credential: MD
Phone: 949-326-7060