SUNNYSIDE PEDIATRICS NPI 1275940611

NPI Information

SUNNYSIDE PEDIATRICS is a primary care clinic center in Salt Lake City, UT. SUNNYSIDE PEDIATRICS NPI is 1275940611. The provider is registered as an organization entity type.
The provider Is Doing Business As Sunnyside Pediatrics, Llc.

The provider's business location address is:

1060 E 100 S
#400
SALT LAKE CITY, UT
ZIP 84102-501
Phone: (801) 521-2640
Fax: (801) 363-6407

The provider's authorized official is Becky Sellers .
The authorized official title is Practice Administrator and has the following contact phone number (801) 526-8353.

The CLIA number assigned to this NPI record is 46D0693585 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/17/2014 and was last updated on 7/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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