Provider Demographics
NPI:1174898019
Name:SUN, DEREK (MD)
Entity type:Individual
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First Name:DEREK
Middle Name:
Last Name:SUN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1600 DIVISADERO ST
Mailing Address - Street 2:ROOM C250
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3010
Mailing Address - Country:US
Mailing Address - Phone:415-885-7464
Mailing Address - Fax:415-885-7876
Practice Address - Street 1:1600 DIVISADERO ST
Practice Address - Street 2:ROOM C250
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3010
Practice Address - Country:US
Practice Address - Phone:415-885-7464
Practice Address - Fax:415-885-7876
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2015-09-01
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Provider Licenses
StateLicense IDTaxonomies
CAA1255322085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging