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General NPI Number Information
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NPI Number | 1750714259
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Entity Type | Organization
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Legal Business Name | SUNSET COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 930 S AVENUE C
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City | YUMA
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State | AZ
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Zip | 85364-3237
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Country | US
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Telephone | 928-819-8999
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 W 24TH ST
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City | YUMA
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State | AZ
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Zip | 85364-6123
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Country | US
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Telephone | 928-819-8999
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Fax |
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Authorized Official
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Title or Position | ACCOUNT RECEIVABLE SUPERVISOR
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Name | MRS. ADA E CARLOS
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Credential |
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Telephone | 928-373-6181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | OTC5046
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License Number State | AZ
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