Provider Demographics
NPI:1659415289
Name:SUNSET CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SUNSET CHIROPRACTIC INC
Other - Org Name:SUNSET CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:PENMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:702-433-5015
Mailing Address - Street 1:600 WHITNEY RANCH DR
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2611
Mailing Address - Country:US
Mailing Address - Phone:702-433-5015
Mailing Address - Fax:702-433-0095
Practice Address - Street 1:600 WHITNEY RANCH DR
Practice Address - Street 2:SUITE 5A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2611
Practice Address - Country:US
Practice Address - Phone:702-433-5015
Practice Address - Fax:702-433-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36742Medicare ID - Type Unspecified