MEDICARE: PETER SUN ONE L,AC

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	AC7103	CA

General Provider Information

NPI Number	:	1578769485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER SUN ONE L,AC

Provider Business Mailing Address
First Line	:	6693 DOWNEY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-2822
Country	:	US
Telephone Number	:	562-634-3300
Fax Number	:	562-634-3313

Provider Business Practice Location Address
First Line	:	6693 DOWNEY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-2822
Country	:	US
Telephone Number	:	562-634-3300
Fax Number	:	562-634-3313

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

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	07/08/2007

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Directions to “ PETER SUN ONE L,AC” Practice Location

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