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Organization
SUNRISE PATHOLOGY SERVICES
Active
Organization
SUNRISE PATHOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY WEBBER-GAMBOA (OWNER)
(725) 243-4242
Entity
Organization
Contact information
Practice address
304 S JONES BLVD STE 7907, LAS VEGAS, NV 89107-2623
(702) 213-5028
(702) 675-9185
Mailing address
304 S JONES BLVD STE 7907, LAS VEGAS, NV 89107-2623
(702) 213-5028
(702) 675-9185
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902400104
—
NV
01
—
=========
IRS
NV
05
—
=========
—
OH
Enumeration date
03/12/2021
Last updated
11/09/2021
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