MEDICARE: DR. ILING SUN LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	LAC5439	CA

General Provider Information

NPI Number	:	1205907854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILING SUN LAC

Provider Business Mailing Address
First Line	:	925 E SAN ANTONIO DR
Second Line	:	SUITE #16
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2210
Country	:	US
Telephone Number	:	562-423-2288
Fax Number	:	562-423-2299

Provider Business Practice Location Address
First Line	:	925 E SAN ANTONIO DR
Second Line	:	SUITE #16
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2210
Country	:	US
Telephone Number	:	562-423-2288
Fax Number	:	562-423-2299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. ILING SUN LAC” Practice Location

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