| Sunrise Multi-specialty Medical Group | |
|
2492 Walnut Ave Suite 110 Tustin CA 92780-6953 | |
| (714) 669-1997 | |
| (714) 573-7424 |
| Full Name | Sunrise Multi-specialty Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2492 Walnut Ave, Tustin, California |
| Authorized Official Name and Position | Sunil Mapara (PRESIDENT) |
| Authorized Official Contact | 7149700911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Multi-specialty Medical Group 2492 Walnut Ave Suite 110 Tustin CA 92780-6953 Ph: (714) 669-1997 | Sunrise Multi-specialty Medical Group 2492 Walnut Ave Suite 110 Tustin CA 92780-6953 Ph: (714) 669-1997 |
| NPI Number | 1104960749 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 4688603392 |
|---|---|
| Medicare Enrollment ID | O20050811000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104960749 | NPI | - | NPPES |
| A37744 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A37744 (California) | Primary |
| 207X00000X | Orthopaedic Surgery | 20A8503 (California) | Secondary |
| Provider Name | Sunil Chimanlal Mapara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386777472 PECOS PAC ID: 3476684721 Enrollment ID: I20100630000287 |
| Provider Name | Pooja M Akotia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316234511 PECOS PAC ID: 8325264807 Enrollment ID: I20140717002204 |
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