Organization
SUNRISE HEALTH CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BESCHELLE JUANMIA LOCKHART (OWNER)
(702) 209-0370
Entity
Organization
Contact information
Practice address
6767 W TROPICANA AVE STE 100, LAS VEGAS, NV 89103-4755
(702) 209-0370
Mailing address
6767 W TROPICANA AVE STE 100, LAS VEGAS, NV 89103-4755
(702) 209-0370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV20141642973
STATE LICENSE
NV
Enumeration date
07/28/2014
Last updated
03/07/2024
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