MEDICARE: SUN MEDICAL SERVICE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	8518	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CC1181	OTHER	NV	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1659387066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN MEDICAL SERVICE CORP

Provider Business Mailing Address
First Line	:	2621 W HORIZON RIDGE PKWY
Second Line	:	SUITE 150
City	:	HENDERSON
State	:	NV
Zip	:	89052-2895
Country	:	US
Telephone Number	:	702-837-6368
Fax Number	:	702-837-0685

Provider Business Practice Location Address
First Line	:	2621 W HORIZON RIDGE PKWY
Second Line	:	SUITE 150
City	:	HENDERSON
State	:	NV
Zip	:	89052-2895
Country	:	US
Telephone Number	:	702-837-6368
Fax Number	:	702-837-0685

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WEN LIANG
Credential	:	M.D.
Telephone Number	:	702-837-6368

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	04/25/2023

Similar Medicare Providers

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Practice Location Address:

2621 W HORIZON RIDGE PKWY , SUITE 150
HENDERSON, NV
89052-2895

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Practice Fax: 702-837-0685

1649239450 — DR. LEONARD D. PARILAK M.D.
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1477853273 — ARTHUR HERPOLSHEIMER MD LTD A PROFESSIONAL CORPORATION
Practice Location Address:

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1912299611 — TIFFANY A SANDY APN
Practice Location Address:

2621 W HORIZON RIDGE PKWY , SUITE 100
HENDERSON, NV
89052-2895

Practice Phone: 702-263-1908
Practice Fax: 702-263-0195

Directions to “SUN MEDICAL SERVICE CORP ” Practice Location

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