Sunrise Shoes and Pedorthic Srvc Corp

NPI #1366688707 in Fair Oaks, California

Provider Information

NPI Number: 1366688707
Entity Type: Organization
Organization Name: Sunrise Shoes and Pedorthic Srvc Corp
Primary Specialty: Specialist
Enumeration Date: Jan 6, 2009
Last Updated: Jan 6, 2009

Practice Location

Address: 5333 SUNRISE BLVD
City: Fair Oaks
State: California
ZIP Code: 95628-3539
Phone: (916) 368-7700

Authorized Official

Name: MR. PETER S WONG, CPED
Title: CEO
Phone: (916) 368-7700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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