Provider Demographics
NPI:1962579623
Name:SUN CITIES MEDICAL GROUP PC
Entity type:Organization
Organization Name:SUN CITIES MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SODHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-815-9733
Mailing Address - Street 1:9179 W THUNDERBIRD RD
Mailing Address - Street 2:STE B105
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4875
Mailing Address - Country:US
Mailing Address - Phone:623-815-9733
Mailing Address - Fax:623-815-9755
Practice Address - Street 1:9179 W THUNDERBIRD RD
Practice Address - Street 2:STE B105
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4875
Practice Address - Country:US
Practice Address - Phone:623-815-9733
Practice Address - Fax:623-815-9755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29330207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ78090Medicare PIN