Provider Demographics
NPI:1184416166
Name:SUN, YANJUN
Entity type:Individual
Prefix:
First Name:YANJUN
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N 1ST AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3245
Mailing Address - Country:US
Mailing Address - Phone:626-461-1232
Mailing Address - Fax:
Practice Address - Street 1:65 N 1ST AVE STE 105
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3245
Practice Address - Country:US
Practice Address - Phone:626-461-1232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19443171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist