Provider Demographics
NPI:1114211497
Name:SUN HEALTHCARE GROUP
Entity Type:Organization
Organization Name:SUN HEALTHCARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:REINMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:425-306-1981
Mailing Address - Street 1:18831 VON KARMAN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1533
Mailing Address - Country:US
Mailing Address - Phone:949-255-7100
Mailing Address - Fax:
Practice Address - Street 1:18831 VON KARMAN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1533
Practice Address - Country:US
Practice Address - Phone:949-255-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60101232261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care