NPIMap

Organization Active NPI

Sunrise Cosmed, a Medical Corporation

  • Clinic/Center
  • Van Nuys, CA
National Provider Identifier
1679626733
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A70235 Issued in CA
Legal business name
SUNRISE COSMED, A MEDICAL CORPORATION
Practice address
6730A White Oak Ave
Van Nuys, CA 91406-5359
Phone
(818) 668-8898
Fax
(818) 668-8893
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Dr. Azadeh Modaresi, MDNPI 1992707004
Title
President
Phone
(818) 668-8898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A70235 CA Primary

Addresses

Primary practice location

6730A White Oak Ave
Van Nuys, CA 91406-5359

Mailing address

PO Box 547
Woodland Hills, CA 91365-0547
Phone (818) 668-8898

National Provider Directory

National Provider Directory

Locations

6730A White Oak Ave
Van Nuys, CA 91406
Phone (818) 668-8898

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1679626733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913650547",
            "telephone_number": "818-668-8898",
            "fax_number": "818-668-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6730A WHITE OAK AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065359",
            "telephone_number": "818-668-8898",
            "fax_number": "818-668-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE COSMED, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "MODARESI",
        "authorized_official_first_name": "AZADEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-668-8898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A70235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.