Healthcare Provider Details

I. General information

NPI: 1487148425
Provider Name (Legal Business Name): SUNSHINE MEDICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 JACKSON ST
SAN FRANCISCO CA
94133-4851
US

IV. Provider business mailing address

817 COFFEE ROAD C3
MODESTO CA
95355-4241
US

V. Phone/Fax

Practice location:
  • Phone: 415-982-2400
  • Fax:
Mailing address:
  • Phone: 209-529-9603
  • Fax: 209-529-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA77809
License Number StateCA

VIII. Authorized Official

Name: YANG SUN
Title or Position: CEO
Credential: MD
Phone: 480-319-4733