MEDICARE: SUNSHINE PEDIATRIC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center	A47754	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528235009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE PEDIATRIC

Provider Business Mailing Address
First Line	:	756 N EUCLID AVE # B
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-2712
Country	:	US
Telephone Number	:	909-986-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	756 N EUCLID AVE # B
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-2712
Country	:	US
Telephone Number	:	909-986-9888
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. CHING CHIH HUANG
Credential	:	MD
Telephone Number	:	909-910-8816

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

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Directions to “SUNSHINE PEDIATRIC ” Practice Location

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