Organization
SUNRISE MEDICAL DIAGNOSTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA KOKHAN (PRESIDENT)
(623) 972-4125
Entity
Organization
Contact information
Practice address
12611 N 103RD AVE, STE # G, SUN CITY, AZ 85351-3422
(623) 972-4125
(623) 972-0265
Mailing address
12611 N 103RD AVE, STE # G, SUN CITY, AZ 85351-3422
(623) 972-4125
(623) 972-0265
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
05/03/2006
Last updated
08/22/2020
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