Healthcare Provider Details

I. General information

NPI: 1275975716
Provider Name (Legal Business Name): XIU PING SUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE BUILDING 90, 4TH FL
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1380 HOWARD STREET, 3RD FLOOR
SAN FRANCISCO CA
94103
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-6907
  • Fax:
Mailing address:
  • Phone: 415-255-3935
  • Fax: 415-255-3564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: