Provider Demographics
NPI:1982907291
Name:SUN CITIES MEDICAL GROUP
Entity Type:Organization
Organization Name:SUN CITIES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SODHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-815-9733
Mailing Address - Street 1:10222 W COGGINS DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3407
Mailing Address - Country:US
Mailing Address - Phone:623-815-9733
Mailing Address - Fax:623-815-9755
Practice Address - Street 1:10222 W COGGINS DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3407
Practice Address - Country:US
Practice Address - Phone:623-815-9733
Practice Address - Fax:623-815-9755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4739363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty