Individual provider Active NPI

Wang-Dar Sun, M.D.

  • Pediatrics Physician
  • Sylmar, CA
National Provider Identifier
1891982377
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A98671 Issued in CA
Practice address
14445 Olive View Dr RM 6B119-H
Sylmar, CA 91342-1437
Phone
(818) 364-3031
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A98671 CA Primary

Addresses

Primary practice location

14445 Olive View Dr RM 6B119-H
Sylmar, CA 91342-1437

Mailing address

14445 Olive View Dr RM 6B119-H
Sylmar, CA 91342-1437
Phone (818) 364-3031

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
I20110310000128 CA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 1052593191 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98671CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Orange County Pediatrics CurrentSince Oct 13, 2018 Accepting new patients

Locations

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1891982377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR RM 6B119-H",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR RM 6B119-H",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "WANG-DAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A98671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.