Healthcare Provider Details

I. General information

NPI: 1871970574
Provider Name (Legal Business Name): SUN MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 LITTLE RIVER TPKE STE 102
ANNANDALE VA
22003-2400
US

IV. Provider business mailing address

7700 LITTLE RIVER TPKE STE 102
ANNANDALE VA
22003-2400
US

V. Phone/Fax

Practice location:
  • Phone: 703-752-4623
  • Fax: 703-762-9978
Mailing address:
  • Phone: 703-752-4623
  • Fax: 703-762-9978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000672
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101038823
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101038823
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305209975
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019004519
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number StateVA
# 8
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number0101230358
License Number StateVA

VIII. Authorized Official

Name: SUN HEE LEE
Title or Position: OWNER OF SUN MEDICAL CENTER, LLC.
Credential:
Phone: 703-752-4623