Healthcare Provider Details
I. General information
NPI: 1235131061
Provider Name (Legal Business Name): KARL TSCHA-NING SUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/11/2005
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8851 CENTER DR STE 401
LA MESA CA
91942-3017
US
IV. Provider business mailing address
8851 CENTER DR STE 401
LA MESA CA
91942-3017
US
V. Phone/Fax
- Phone: 619-668-1550
- Fax: 619-668-1554
- Phone: 760-598-8058
- Fax: 760-598-8078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | A68612 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | A68612 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: