Healthcare Provider Details

I. General information

NPI: 1922592211
Provider Name (Legal Business Name): MENGXUE SUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FIONA SUN

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 E MISSISSIPPI AVE STE 310
GLENDALE CO
80246-3052
US

IV. Provider business mailing address

4100 E MISSISSIPPI AVE STE 310
GLENDALE CO
80246-3052
US

V. Phone/Fax

Practice location:
  • Phone: 303-326-0645
  • Fax:
Mailing address:
  • Phone: 303-326-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: