Organization
SUNRISE PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY BURNETT (VP)
(702) 262-9676
Entity
Organization
Contact information
Practice address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109-2317
(702) 262-9676
Mailing address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109-2317
(702) 262-9676
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100501944
—
NV
05
—
915019
—
AZ
01
—
CC8707
BCBS
NV
05
—
XGG007680
—
CA
Enumeration date
07/07/2006
Last updated
06/17/2008
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