Provider Demographics
NPI:1124315213
Name:SUN, XIAOCHU CAI (LAC)
Entity type:Individual
Prefix:
First Name:XIAOCHU
Middle Name:CAI
Last Name:SUN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:CAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:5150 GRAVES AVE STE 12H
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5015
Mailing Address - Country:US
Mailing Address - Phone:408-874-6588
Mailing Address - Fax:408-427-9234
Practice Address - Street 1:5150 GRAVES AVE STE 12H
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5015
Practice Address - Country:US
Practice Address - Phone:408-874-6588
Practice Address - Fax:408-427-9234
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14339171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist