Individual provider Active NPI

Stephen Sun, DO

  • Internal Medicine Physician
  • Coronado, CA
National Provider Identifier
1437644242
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A18000 Issued in CA
Practice address
250 Prospect PL
Coronado, CA 92118-1943
Phone
(619) 522-3600
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 20A18000 CA Primary

Addresses

Primary practice location

250 Prospect PL
Coronado, CA 92118-1943

Mailing address

100 Park PLZ Apt 719
San Diego, CA 92101-6820
Phone (408) 891-0512

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518002239 CA Practitioner - Internal Medicine 4587063888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians
San Diego Critical Care Medical Group IncGroup PAC ID 7911083886, 74 clinicians

Practice addresses (Care Compare)

250 Prospect PL
Coronado, CA 92118-1943
Phone (619) 522-3600

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 461-1920

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18000CAMDVeterinarian
20A18000CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Jul 1, 2021 Accepting new patients
San Diego Critical Care Medical Group, Inc Internal Medicine CurrentSince May 1, 2021 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1437644242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK PLZ APT 719",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016820",
            "telephone_number": "408-891-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PROSPECT PL",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181943",
            "telephone_number": "619-522-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A18000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

Verify at the official NPI Registry.