Organization Active NPI

Karl Sun, M.D. Inc.

  • Cardiovascular Disease Physician
  • San Diego, CA
National Provider Identifier
1801258843
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A68612 Issued in CA
Legal business name
KARL SUN, M.D. INC.
Practice address
5555 Reservoir Drive
Suite 112
San Diego, CA 92120
Phone
(619) 287-7060
Fax
(619) 287-7078
NPI assigned
Mar 28, 2016
Last updated
Mar 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Mr. Karl Sun, M.D.NPI 1235131061
Title
Physician/Owner
Phone
(619) 287-7060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A68612 CA Primary
Nuclear Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207UN0901X A68612 CA

Addresses

Primary practice location

5555 Reservoir Drive
Suite 112
San Diego, CA 92120

Mailing address

5555 Reservoir Drive
Suite 112
San Diego, CA 92120
Phone (619) 287-7060

Other identifiers 1

IdentifierTypeStateIssuer
00A686120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160505001424 CA Part B Supplier - Clinic/Group Practice 4880993203 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

5555 Reservoir Dr
Ste 112
San Diego, CA 92120
Phone (619) 287-7060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1801258843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DRIVE",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-287-7060",
            "fax_number": "619-287-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DRIVE",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-287-7060",
            "fax_number": "619-287-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARL SUN, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "619-287-7060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A68612",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "A68612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A686120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.