NPIMap

Organization Active NPI

Sunder Medical Clinic, Inc.

  • Cardiovascular Disease Physician
  • Ridgecrest, CA
National Provider Identifier
1962776740
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A26701 Issued in CA
Legal business name
SUNDER MEDICAL CLINIC, INC.
Practice address
1535 N China Lake Blvd
Suite a
Ridgecrest, CA 93555-2667
Phone
(760) 446-1699
Fax
(661) 726-3723
NPI assigned
Feb 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Dr. Shun K Sunder, M.D.NPI 1376557132
Title
President
Phone
(661) 726-3058

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X A26701 CA Primary

Addresses

Primary practice location

1535 N China Lake Blvd
Suite a
Ridgecrest, CA 93555-2667

Mailing address

43860 10TH St W
Lancaster, CA 93534-4848
Phone (661) 726-3060

Other identifiers 1

IdentifierTypeStateIssuer
00A267010MedicaidCA

Other names 1

  • SUNDER HEART INSTITUTE & VASCULAR MEDICAL CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081202000419 CA Part B Supplier - Clinic/Group Practice 2668531443 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
Practice locations: Lancaster, CA; Ridgecrest, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sunder Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1962776740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43860 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344848",
            "telephone_number": "661-726-3060",
            "fax_number": "661-726-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 N CHINA LAKE BLVD",
            "address_2": "SUITE A",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552667",
            "telephone_number": "760-446-1699",
            "fax_number": "661-726-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDER MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "SUNDER",
        "authorized_official_first_name": "SHUN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-726-3058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A26701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A267010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNDER HEART INSTITUTE & VASCULAR MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.