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NPI Code Detail

MEDICARE: SUN MEDICAL GROUP, INC.

MEDICARE: SUN MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1114673902
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUN MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 519
Second Line :
City : LAKE FOREST
State : CA
Zip : 92609-0519
Country : US
Telephone Number : 714-337-9393
Fax Number :
Provider Business Practice Location Address
First Line : 1711 W KATELLA AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92804-6450
Country : US
Telephone Number : 714-337-9393
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MIRANDA FAITH DE LUNA
Credential : MD
Telephone Number : 316-214-7764
Provider Enumeration Date : 03/01/2022
Last Update Date : 03/01/2022

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Directions to “SUN MEDICAL GROUP, INC. ” Practice Location

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