MEDICARE: SUNRISE SERVICES ENTERPRISE

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
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1962234237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE SERVICES ENTERPRISE

Provider Business Mailing Address
First Line	:	2714 W FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-5151
Country	:	US
Telephone Number	:	323-514-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 W FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-5151
Country	:	US
Telephone Number	:	323-514-0121
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FRAN CLANEISE HATCHER
Credential	:
Telephone Number	:	323-514-0121

Provider Enumeration Date	:	08/15/2024
Last Update Date	:	08/15/2024

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Directions to “SUNRISE SERVICES ENTERPRISE ” Practice Location

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