NPIMap

Individual provider Active NPI

Christopher Sun, MD

  • Internal Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1245407105
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A102353 Issued in CA
Practice address
520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041
Phone
(310) 376-8816
Fax
(310) 374-2806
NPI assigned
May 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A102353 CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041

Mailing address

520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041
Phone (310) 376-8816

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csun196697@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090217000504 CA Practitioner - Internal MedicinePractitioner - Family Practice 3577628072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

Laguna Niguel, CA 92677

520 N Prospect Ave
Redondo Beach, CA 90277-3033

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A102353CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Internal Medicine CurrentSince Aug 5, 2018 Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Aug 5, 2018 Accepting new patients
Providence Medical Institute Internal Medicine Current Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

520 N Prospect Ave
Redondo Beach, CA 90277
Phone (310) 376-8816

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: csun196697@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1245407105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csun196697@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "520 N Prospect Ave",
            "address_2": "Suite 103",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902773041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.