Provider Demographics
NPI:1689733123
Name:SUN SUN INC
Entity type:Organization
Organization Name:SUN SUN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED PHARMACIS
Authorized Official - Phone:626-288-6560
Mailing Address - Street 1:600 N GARFIELD AVE
Mailing Address - Street 2:STE 107A
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1166
Mailing Address - Country:US
Mailing Address - Phone:626-288-6560
Mailing Address - Fax:626-288-6481
Practice Address - Street 1:600 N GARFIELD AVE
Practice Address - Street 2:STE 107A
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1166
Practice Address - Country:US
Practice Address - Phone:626-288-6560
Practice Address - Fax:626-288-6481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY437013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA437010Medicaid
0502698OtherOTHER ID NUMBER
0502698OtherOTHER ID NUMBER