Organization
SUN RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANNTEJ S SRA M.D. (CEO)
(602) 705-1353
Entity
Organization
Contact information
Practice address
16222 N 59TH AVE STE C150, GLENDALE, AZ 85306-1747
(623) 815-8200
(623) 815-8299
Mailing address
13943 N 91ST AVE STE A102, PEORIA, AZ 85381-3688
(623) 815-2000
(623) 815-8299
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
28033
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260762
—
AZ
Enumeration date
03/20/2007
Last updated
07/16/2023
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