| NPI | 1790371888 |
|---|---|
| Doing Business As | SUNNYLANE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | NOHEMY GARCIA Credentialing Administrator 405-682-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2022-11-04 |