Healthcare Provider Details

I. General information

NPI: 1477263317
Provider Name (Legal Business Name): SUNSHINE MEDICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 N MESA ST STE 400
EL PASO TX
79912-5424
US

IV. Provider business mailing address

2311 N MESA ST STE H
EL PASO TX
79902-3575
US

V. Phone/Fax

Practice location:
  • Phone: 915-320-9476
  • Fax:
Mailing address:
  • Phone: 915-479-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NAHID VANDSHEKARI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 915-320-9476