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General NPI Number Information
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NPI Number | 1093116733
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Entity Type | Organization
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Legal Business Name | SUNRISE MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 18731 N REEMS RD STE F680
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City | SURPRISE
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State | AZ
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Zip | 85374-8644
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Country | US
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Telephone | 623-933-0301
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Fax | 623-933-0224
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Provider Business Mailing Address
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Address Line | 13634 N 93RD AVE STE 100
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City | PEORIA
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State | AZ
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Zip | 85381-4915
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Country | US
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Telephone | 623-933-0301
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Fax | 623-933-0224
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MAGGIE ZEISS
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Credential |
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Telephone | 623-933-1998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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