Organization
SUNRISE COSMED, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZADEH MODARESI MD (PRESIDENT)
(818) 668-8898
Entity
Organization
Contact information
Practice address
6730A WHITE OAK AVE, VAN NUYS, CA 91406-5359
(818) 668-8898
(818) 668-8893
Mailing address
PO BOX 547, WOODLAND HILLS, CA 91365-0547
(818) 668-8898
(818) 668-8893
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A70235
CA
Other
Enumeration date
01/19/2007
Last updated
07/30/2007
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