=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497712715
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM M SUN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2006
-----------------------------------------------------
Last Update Date | 03/25/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 N GARFIELD AVE STE 306
-----------------------------------------------------
City | MONTEREY PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91754-1242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-572-0660
-----------------------------------------------------
Fax | 626-572-0860
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 630 ARBOLADA DR
-----------------------------------------------------
City | ARCADIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-572-0660
-----------------------------------------------------
Fax | 626-572-0860
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number | C43035
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------