1780900530 NPI number — ERIC CHUNG SUN MD, PHD

Table of content: ERIC CHUNG SUN MD, PHD (NPI 1780900530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780900530 NPI number — ERIC CHUNG SUN MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUN
Provider First Name:
ERIC
Provider Middle Name:
CHUNG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780900530
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
751 S BASCOM AVE, DEPT OF MEDICINE, 4TH FL
Provider Second Line Business Mailing Address:
SANTA CLARA VALLEY MEDICAL CENTER
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-885-6305
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305-2200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-723-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: A117742 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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