Organization
SUNRISE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN PERRITT (CFO)
(702) 731-8012
Entity
Organization
Contact information
Practice address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109
(702) 731-8115
(702) 784-7844
Mailing address
3196 S MARYLAND PKWY, SUITE 101, LAS VEGAS, NV 89109
(702) 731-8099
(702) 731-8292
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2000403 543
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100501944
—
NV
05
—
915019
—
AZ
01
—
CC8707
BCBS NV
NV
05
—
XGG007680
—
CA
Enumeration date
02/16/2006
Last updated
07/08/2008
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