Sunrise Multispecialist Medical Center | |
867 S Tustin St Orange CA 92866-3426 | |
(714) 771-1420 | |
(714) 771-6918 |
Full Name | Sunrise Multispecialist Medical Center |
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Speciality | Clinic/Center |
Location | 867 S Tustin St, Orange, California |
Authorized Official Name and Position | William H. Nuesse (MEDICAL DIRECTOR) |
Authorized Official Contact | 7147711420 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sunrise Multispecialist Medical Center 867 S Tustin St Orange CA 92866-3426 Ph: (714) 771-1420 | Sunrise Multispecialist Medical Center 867 S Tustin St Orange CA 92866-3426 Ph: (714) 771-1420 |
NPI Number | 1508994088 |
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Provider Enumeration Date | 02/28/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 0143257659 |
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Medicare Enrollment ID | O20050726000604 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508994088 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Peter E Wu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023193117 PECOS PAC ID: 0143273805 Enrollment ID: I20050223000217 |
Provider Name | Mary Ann Nuesse |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689633455 PECOS PAC ID: 7315082112 Enrollment ID: I20100304000542 |
Provider Name | William H Nuesse |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952360729 PECOS PAC ID: 1052456852 Enrollment ID: I20100304000572 |
Provider Name | Kenneth E Grubbs |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588773295 PECOS PAC ID: 6507082369 Enrollment ID: I20140812002576 |
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