Healthcare Provider Details

I. General information

NPI: 1710828421
Provider Name (Legal Business Name): MS. HAI XIA SUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 HUNTINGTON DR STE 205
PASADENA CA
91107-5645
US

IV. Provider business mailing address

3675 HUNTINGTON DR STE 205
PASADENA CA
91107-5645
US

V. Phone/Fax

Practice location:
  • Phone: 626-228-5678
  • Fax: 626-608-2393
Mailing address:
  • Phone: 626-228-5678
  • Fax: 626-608-2393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number20975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: