Healthcare Provider Details

I. General information

NPI: 1043709587
Provider Name (Legal Business Name): SUNRISE CBAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14360 WHITTIER BLVD
WHITTIER CA
90605-2103
US

IV. Provider business mailing address

4275 MARIETTA CT
CONCORD CA
94518-1831
US

V. Phone/Fax

Practice location:
  • Phone: 415-290-3986
  • Fax:
Mailing address:
  • Phone: 415-290-3986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAKOB KARAPETYAN
Title or Position: OWNER/MANAGING DIRECTOR
Credential:
Phone: 415-290-3986