Organization
SUN CITY IMAGING, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB J MUSALLAM M.D. (PRESIDENT)
(602) 943-9200
Entity
Organization
Contact information
Practice address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(623) 977-7211
Mailing address
PO BOX 27340, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006339
—
AZ
01
—
1Z7135
HEALTH NET OF AZ
AZ
Enumeration date
03/08/2006
Last updated
12/05/2007
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