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General NPI Number Information
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NPI Number | 1306881461
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Entity Type | Organization
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Legal Business Name | SUN MEDICAL GROUP
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2034 E SOUTHERN AVE SUITE M
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City | TEMPE
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State | AZ
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Zip | 85282-7522
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Country | US
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Telephone | 480-831-7601
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Fax |
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Provider Business Mailing Address
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Address Line | 1753 E BROADWAY RD SUITE 101-268
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City | TEMPE
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State | AZ
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Zip | 85282-2081
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Country | US
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Telephone | 480-831-7601
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. LINDA H. STARR
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Credential |
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Telephone | 800-836-2904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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