Healthcare Provider Details

I. General information

NPI: 1578265450
Provider Name (Legal Business Name): WENDY YUWENG SUN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLAZA ROOM 3108
LOS ANGELES CA
90095-1752
US

IV. Provider business mailing address

757 WESTWOOD PLAZA, PEDIATRICS
LOS ANGELES CA
90095-7419
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-9124
  • Fax: 310-267-3842
Mailing address:
  • Phone: 310-267-9124
  • Fax: 310-267-3842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA206775
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: