Healthcare Provider Details
I. General information
NPI: 1942870191
Provider Name (Legal Business Name): SUNRISE NEUROLOGY ASSOCIATES APC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2021
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9041 MAGNOLIA AVE STE 9
RIVERSIDE CA
92503-3941
US
IV. Provider business mailing address
9041 MAGNOLIA AVE STE 9
RIVERSIDE CA
92503-3941
US
V. Phone/Fax
- Phone: 951-784-7444
- Fax:
- Phone: 951-784-7444
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAJAN PREET
ARORA
Title or Position: VICE-PRESIDENT AND SECRETARY
Credential: MD
Phone: 909-569-9536