Provider Demographics
NPI:1750561742
Name:SUNCENTER MEDICAL OFFICES, LLC
Entity type:Organization
Organization Name:SUNCENTER MEDICAL OFFICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:E. SOPHIA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MALAIKA
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-345-3708
Mailing Address - Street 1:6915 CALLE ALMERIA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1093
Mailing Address - Country:US
Mailing Address - Phone:505-345-3708
Mailing Address - Fax:505-345-3708
Practice Address - Street 1:6915 CALLE ALMERIA NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1093
Practice Address - Country:US
Practice Address - Phone:505-345-3708
Practice Address - Fax:505-345-3708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy