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NPI Code Detail

MEDICARE: DR. SUSAN SUN

MEDICARE: DR. SUSAN SUN
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
1183500000XPharmacist65879CA

General Provider Information

NPI Number : 1891071346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN SUN
Provider Business Mailing Address
First Line : 1630 OCEAN AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-1718
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1630 OCEAN AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-1718
Country : US
Telephone Number : 415-239-0804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2011
Last Update Date : 10/28/2011

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Directions to “ DR. SUSAN SUN ” Practice Location

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