Provider Demographics
NPI:1649343096
Name:SUNSHINE PEDIATRICS, INC.
Entity type:Organization
Organization Name:SUNSHINE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:YASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-432-6669
Mailing Address - Street 1:3009 N BALLAS RD
Mailing Address - Street 2:SUITE 259C
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2322
Mailing Address - Country:US
Mailing Address - Phone:314-432-6669
Mailing Address - Fax:314-432-7333
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:SUITE 259C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-432-6669
Practice Address - Fax:314-432-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty