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General NPI Number Information
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NPI Number | 1578844411
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Entity Type | Organization
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Legal Business Name | SUNBURST MEDICINE PLLC
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 3101 E SHEA BLVD STE 114
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City | PHOENIX
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State | AZ
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Zip | 85028-3209
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Country | US
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Telephone | 480-544-7884
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Fax | 480-781-4801
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Provider Business Mailing Address
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Address Line | 6336 E COCHISE RD
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-1252
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Country | US
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Telephone | 480-455-9800
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Fax |
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Authorized Official
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Title or Position | SELF
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Name | NACCHAL NACHIAPPAN
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Credential | MD
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Telephone | 480-455-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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