Provider Demographics
NPI:1487610937
Name:SUNENSHINE, PETER JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:SUNENSHINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 SONOMA STREET
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3033
Mailing Address - Country:US
Mailing Address - Phone:530-999-2532
Mailing Address - Fax:530-999-2532
Practice Address - Street 1:2420 SONOMA STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3033
Practice Address - Country:US
Practice Address - Phone:530-999-2533
Practice Address - Fax:530-999-2532
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1105682084N0400X, 2084V0102X, 2085R0202X, 2085R0204X
AZ355132084N0400X, 2085R0202X, 2085R0204X, 2085N0700X
CAC543302085N0700X
CODR.00644282085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ143564Medicaid
FL003855100Medicaid
AZ143564Medicaid
AZZ143055Medicare PIN
FL003855100Medicaid
AZZ110422Medicare PIN
AZZ110421Medicare PIN
FLFG495YMedicare PIN
FLFG495ZMedicare PIN