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General NPI Number Information
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NPI Number | 1750604989
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Entity Type | Organization
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Legal Business Name | SUNRIDGE MEDICAL WELLNES CENTER
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 14200 N NORTHSIGHT BLVD SUITE 160
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3947
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Country | US
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Telephone | 480-659-9135
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Fax | 800-659-9035
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Provider Business Mailing Address
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Address Line | 14200 N NORTHSIGHT BLVD SUITE 160
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3947
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Country | US
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Telephone | 480-659-9135
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Fax | 800-659-9035
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GIOACCHINO VINCENZO FRANCO
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Credential | NMD
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Telephone | 480-659-9155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 04-839
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License Number State | AZ
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