Healthcare Provider Details

I. General information

NPI: 1316895048
Provider Name (Legal Business Name): SUNRISE MED SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S HILL ST STE P32
LOS ANGELES CA
90014-1707
US

IV. Provider business mailing address

607 S HILL ST STE P32
LOS ANGELES CA
90014-1707
US

V. Phone/Fax

Practice location:
  • Phone: 747-977-0998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KEVORK GUMUSHIAN
Title or Position: CEO
Credential:
Phone: 747-977-0998