Captain, Sun

Captain, Sun is an individual health care provider with primary practice located at 3031 Telegraph Ave Ste 217 , Berkeley CA 94705-2053. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Captain, Sun can be contacted via phone (510) 981-8222.

Contact Information

Primary practice address
3031 Telegraph Ave Ste 217 Berkeley CA 94705-2053
Fax: (510) 981-8228
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA17206 California

Profile Details

NPI number 1265791891
LBN Legal business name Captain, Sun
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2012
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265791891 NPPES
California Other PA 17206 PA LICENSE

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