Basic Information
| Provider Information | |||||||||
| NPI: | 1548254147 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUN HEALTH CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 53568 | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850723568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235445068 | ||||||||
| FaxNumber: | 6235445093 | ||||||||
| Practice Location | |||||||||
| Address1: | 10401 W THUNDERBIRD BLVD | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239777211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BROSER | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6235445079 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207V00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207T00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery | 2084N0400X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.