Healthcare Provider Details

I. General information

NPI: 1073801056
Provider Name (Legal Business Name): ALL-STAR PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 E BASELINE RD STE 119
GILBERT AZ
85234-2965
US

IV. Provider business mailing address

4915 E BASELINE RD STE 119
GILBERT AZ
85234-2969
US

V. Phone/Fax

Practice location:
  • Phone: 480-832-0480
  • Fax:
Mailing address:
  • Phone: 480-832-0480
  • Fax: 480-832-0490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVE MOUSSER
Title or Position: OWNER
Credential: M.D.
Phone: 480-832-0480