Provider Demographics
NPI:1093116733
Name:SUNRISE MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:SUNRISE MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-933-1998
Mailing Address - Street 1:13634 N 93RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4915
Mailing Address - Country:US
Mailing Address - Phone:623-933-0301
Mailing Address - Fax:623-933-0224
Practice Address - Street 1:18731 N REEMS RD STE F680
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8644
Practice Address - Country:US
Practice Address - Phone:623-933-0301
Practice Address - Fax:623-933-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE60567Medicare UPIN
AZI12205Medicare UPIN
AZG96758Medicare UPIN
AZE79207Medicare UPIN
AZF62957Medicare UPIN