Healthcare Provider Details

I. General information

NPI: 1639035041
Provider Name (Legal Business Name): GANG SUN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 DE GUIGNE DR STE 201
SUNNYVALE CA
94085-3875
US

IV. Provider business mailing address

2468 W BAYSHORE RD APT 4
PALO ALTO CA
94303-3538
US

V. Phone/Fax

Practice location:
  • Phone: 408-393-2525
  • Fax:
Mailing address:
  • Phone: 408-393-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: