Sunrise Medical Diagnostic, Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

SUNRISE MEDICAL DIAGNOSTIC, INC

Practice address

12611 N 103Rd Ave
Ste # G
Sun City, AZ 85351-3422

Phone

(623) 972-4125

Fax

(623) 972-0265

NPI assigned

May 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marina Kokhan

Title

President

Phone

(623) 972-4125

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609834159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12611 N 103RD AVE",
            "address_2": "STE # G",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513422",
            "telephone_number": "623-972-4125",
            "fax_number": "623-972-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12611 N 103RD AVE",
            "address_2": "STE # G",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513422",
            "telephone_number": "623-972-4125",
            "fax_number": "623-972-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MEDICAL DIAGNOSTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOKHAN",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-972-4125"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Judith Swift, PT
• Nancy J Swintek, LCSW
• Michael C Switzer, M.D.

• Physiological Laboratory in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Physiological Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.