Healthcare Provider Details

I. General information

NPI: 1992640114
Provider Name (Legal Business Name): SUNNY HYATT RDMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2539 E EMELITA AVE
MESA AZ
85204-4606
US

IV. Provider business mailing address

2539 E EMELITA AVE
MESA AZ
85204-4606
US

V. Phone/Fax

Practice location:
  • Phone: 480-452-5753
  • Fax:
Mailing address:
  • Phone: 480-452-5753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberARDMS
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: