Provider Demographics
NPI:1578844411
Name:SUNBURST MEDICINE PLLC
Entity Type:Organization
Organization Name:SUNBURST MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF
Authorized Official - Prefix:
Authorized Official - First Name:NACCHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NACHIAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-455-9800
Mailing Address - Street 1:6336 E COCHISE RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1252
Mailing Address - Country:US
Mailing Address - Phone:480-455-9800
Mailing Address - Fax:
Practice Address - Street 1:3101 E SHEA BLVD STE 114
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3209
Practice Address - Country:US
Practice Address - Phone:480-544-7884
Practice Address - Fax:480-781-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty