Provider Demographics
NPI:1861427817
Name:SUN CITY MOBILE DIAGNOSTIC LLC
Entity type:Organization
Organization Name:SUN CITY MOBILE DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGHDASARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-747-3553
Mailing Address - Street 1:10728 N 154TH LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379
Mailing Address - Country:US
Mailing Address - Phone:480-747-3553
Mailing Address - Fax:623-584-2723
Practice Address - Street 1:10728 N 154TH LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379
Practice Address - Country:US
Practice Address - Phone:480-747-3553
Practice Address - Fax:623-584-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty