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NPI 1972700359

NPI 1972700359 : SUNRISE INTERNAL MEDICINE PC : QUEEN CREEK, AZ

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General NPI Number Information
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    NPI Number           |    1972700359
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    Entity Type          |    Organization 
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    Legal Business Name  |    SUNRISE INTERNAL MEDICINE PC 
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Dates
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    Enumeration Date     |    06/29/2007
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    Last Update Date     |    01/06/2025
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Provider Practice Location Address
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    Address Line         |    22707 S ELLSWORTH RD STE 105 
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    City                 |    QUEEN CREEK
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    State                |    AZ
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    Zip                  |    85142-6132
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    Country              |    US
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    Telephone            |    480-888-1900
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    Fax                  |    480-888-1934
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Provider Business Mailing Address
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    Address Line         |    22707 S ELLSWORTH RD STE 105 
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    City                 |    QUEEN CREEK
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    State                |    AZ
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    Zip                  |    85142-6132
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    Country              |    US
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    Telephone            |    480-888-1900
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    Fax                  |    480-888-1934
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Authorized Official
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    Title or Position    |    PHYSICIAN
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    Name                 |     FREDERIC F LUO 
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    Credential           |    MD
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    Telephone            |    480-888-1900
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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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