Healthcare Provider Details

I. General information

NPI: 1972296143
Provider Name (Legal Business Name): NEW SUNSHINE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 MISSION ST STE B
SOUTH PASADENA CA
91030-3083
US

IV. Provider business mailing address

630 MISSION ST STE B
SOUTH PASADENA CA
91030-3083
US

V. Phone/Fax

Practice location:
  • Phone: 626-799-9888
  • Fax: 626-977-9777
Mailing address:
  • Phone: 626-799-9888
  • Fax: 626-977-9777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PINGRONG GU
Title or Position: CEO
Credential:
Phone: 626-799-9888