MEDICARE: PEDIATRIC ASSOCIATES OF IOWA CITY AND CORALVILLE, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1265523062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC ASSOCIATES OF IOWA CITY AND CORALVILLE, LLP

Provider Business Mailing Address
First Line	:	605 E JEFFERSON ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-2426
Country	:	US
Telephone Number	:	319-351-1448
Fax Number	:	319-351-9367

Provider Business Practice Location Address
First Line	:	605 E JEFFERSON ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-2426
Country	:	US
Telephone Number	:	319-351-1448
Fax Number	:	319-351-9367

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ALEJANDRO GONZALO GALINDO
Credential	:
Telephone Number	:	319-351-1448

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	01/04/2016

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