Healthcare Provider Details

I. General information

NPI: 1487823472
Provider Name (Legal Business Name): SUN HEALTH MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 W THUNDERBIRD BLVD ATTN: HOSPITALIST OFFICE
SUN CITY AZ
85351-3004
US

IV. Provider business mailing address

PO BOX 1278 ATTN: MINDY OGDEN
SUN CITY AZ
85372-1278
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-5622
  • Fax: 623-815-2391
Mailing address:
  • Phone: 623-544-5075
  • Fax: 623-544-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL R BROSOR
Title or Position: VICE PRESIDENT, PHYSICIAN SERVICES
Credential:
Phone: 623-544-5079