Sun Captain, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17206 Issued in CA

Practice address

3031 Telegraph Ave Ste 217
Berkeley, CA 94705-2053

Phone

(510) 981-8222

Fax

(510) 981-8228

NPI assigned

May 16, 2012

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265791891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 VAN NESS AVE APT 52",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023263",
            "telephone_number": "415-794-8441",
            "fax_number": "510-981-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 TELEGRAPH AVE STE 217",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052053",
            "telephone_number": "510-981-8222",
            "fax_number": "510-981-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPTAIN",
        "first_name": "SUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA 17206",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Lam Cao, RN
• Bei Cao
• Don-Anthony L. Capone, PSY.D.
• Claire Capor, M.S.W.
• Norian Caporale-Berkowitz
• Deana Capurro
• Carbon Health Medical Group of California PC
• Carbon Health Medical Group of California PC (Carbon Health)
• Carbon Health Primary Care of California PC
• Carbon Health Primary Care of California PC

• Medical Physician Assistant in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.