# SUNRISE PATHOLOGY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538744347
- **Authorized official:** ASHLEY WEBBER-GAMBOA (OWNER)
- **Authorized official phone:** (725) 243-4242

## Contact information

- **Practice address:** 304 S JONES BLVD STE 7907, LAS VEGAS, NV 89107-2623
- **Practice address phone:** (702) 213-5028
- **Practice address fax:** (702) 675-9185
- **Mailing address:** 304 S JONES BLVD STE 7907, LAS VEGAS, NV 89107-2623
- **Mailing address phone:** (702) 213-5028
- **Mailing address fax:** (702) 675-9185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 374700000X | Technician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2021
- **Last updated:** 11/09/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1902400104 | — | NV |
| 01 | — | ========= | IRS | NV |
| 05 | — | ========= | — | OH |