Provider Demographics
NPI:1548999014
Name:TSUN, FRECO (DNAP)
Entity type:Individual
Prefix:
First Name:FRECO
Middle Name:
Last Name:TSUN
Suffix:
Gender:F
Credentials:DNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 MAYWIND WAY
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5517
Mailing Address - Country:US
Mailing Address - Phone:626-283-7978
Mailing Address - Fax:
Practice Address - Street 1:2210 MAYWIND WAY
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5517
Practice Address - Country:US
Practice Address - Phone:626-283-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001801367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered