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General NPI Number Information
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NPI Number | 1043675309
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Entity Type | Organization
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Legal Business Name | SUNSHINE HEALTHCARE, LLC
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 638 OFFICE PARKWAY
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City | CREVE COEUR
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State | MO
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Zip | 63141
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Country | US
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Telephone | 314-736-1116
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Fax | 314-736-1198
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Provider Business Mailing Address
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Address Line | 15455 MANCHESTER ROAD UNIT 213
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City | BALLWIN
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State | MO
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Zip | 63022-0213
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Country | US
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Telephone | 314-736-1116
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Fax | 314-736-1198
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAPING SUN
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Credential | MD
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Telephone | 314-736-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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