Provider Demographics
NPI:1801192059
Name:SUNSET SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SUNSET SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:PRACTICE MANAGER
Authorized Official - Phone:702-262-0079
Mailing Address - Street 1:9120 W RUSSELL RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1229
Mailing Address - Country:US
Mailing Address - Phone:702-476-2897
Mailing Address - Fax:702-685-6910
Practice Address - Street 1:9120 W RUSSELL RD
Practice Address - Street 2:SUITE #100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1229
Practice Address - Country:US
Practice Address - Phone:702-476-2897
Practice Address - Fax:702-685-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV101116Medicare UPIN