Healthcare Provider Details

I. General information

NPI: 1649191636
Provider Name (Legal Business Name): YUANDONG SUN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S CHANDLER AVE APT E
MONTEREY PARK CA
91754-2737
US

IV. Provider business mailing address

211 S CHANDLER AVE APT E
MONTEREY PARK CA
91754-2737
US

V. Phone/Fax

Practice location:
  • Phone: 626-678-3248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: