Organization Active NPI

Sunrise Diagnostic, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Anaheim, CA
National Provider Identifier
1982032413
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20A11362 Issued in CA
Legal business name
SUNRISE DIAGNOSTIC, INC.
Practice address
2500 E Ball Rd
Suite 220
Anaheim, CA 92806-5054
Phone
(562) 366-3388
Fax
(866) 214-8477
NPI assigned
Oct 18, 2013
Last updated
Oct 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Authorized official

Name
Dr. Melanie Willis, D.O.
Title
President
Phone
(714) 326-6855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20A11362 CA Primary

Addresses

Primary practice location

2500 E Ball Rd
Suite 220
Anaheim, CA 92806-5054

Mailing address

2500 E Ball Rd
Suite 220
Anaheim, CA 92806-5054
Phone (562) 366-3388

National Provider Directory

National Provider Directory

Locations

2500 E Ball Rd
Ste 220
Anaheim, CA 92806
Phone (562) 366-3388

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1982032413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E BALL RD",
            "address_2": "SUITE 220",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065054",
            "telephone_number": "562-366-3388",
            "fax_number": "866-214-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E BALL RD",
            "address_2": "SUITE 220",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065054",
            "telephone_number": "562-366-3388",
            "fax_number": "866-214-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE DIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-326-6855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A11362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.