| Sun Ray Holding Company, Llc | |
|
31641 Auto Center Dr Room 1 Lake Elsinore CA 92530-4535 | |
| (772) 247-1782 | |
| (772) 210-2758 |
| Full Name | Sun Ray Holding Company, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 31641 Auto Center Dr, Lake Elsinore, California |
| Authorized Official Name and Position | Edward Rousseau (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 7722667682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Ray Holding Company, Llc Po Box 101774 Pasadena CA 91189-1774 Ph: (772) 247-1428 | Sun Ray Holding Company, Llc 31641 Auto Center Dr Room 1 Lake Elsinore CA 92530-4535 Ph: (772) 247-1782 |
| NPI Number | 1508227562 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 10/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508227562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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