Basic Information
| Provider Information | |||||||||
| NPI: | 1841561347 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNSET ANESTHESIA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6020 E ARBOR AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852066102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809851700 | ||||||||
| FaxNumber: | 4803963659 | ||||||||
| Practice Location | |||||||||
| Address1: | 6020 E ARBOR AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852066102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809851700 | ||||||||
| FaxNumber: | 4803963659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2012 | ||||||||
| LastUpdateDate: | 01/16/2012 | ||||||||
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| AuthorizedOfficialLastName: | HARDING | ||||||||
| AuthorizedOfficialFirstName: | BRENDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4809851700 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | DIGESTIVE DISEASE CONSULTANTS, PC | ||||||||
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| AuthorizedOfficialCredential: | FACMPE | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.