Provider Demographics
NPI:1700275351
Name:SUNSERI, ANTHONY (RPSGT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SUNSERI
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LITTON DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5077
Mailing Address - Country:US
Mailing Address - Phone:530-273-0360
Mailing Address - Fax:530-273-0390
Practice Address - Street 1:140 LITTON DR
Practice Address - Street 2:SUITE 230
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5077
Practice Address - Country:US
Practice Address - Phone:530-273-0360
Practice Address - Fax:530-273-0390
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19192246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other