Healthcare Provider Details

I. General information

NPI: 1275803496
Provider Name (Legal Business Name): DESERT VIEW PEDIATRICS, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 E SWEETWATER AVE
PHOENIX AZ
85032-6930
US

IV. Provider business mailing address

727 E BETHANY HOME RD SUITE A-101
PHOENIX AZ
85014-2198
US

V. Phone/Fax

Practice location:
  • Phone: 480-200-2296
  • Fax: 602-279-5890
Mailing address:
  • Phone: 602-279-2400
  • Fax: 602-279-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD ABEL DALOTTO
Title or Position: ADMINISTRATOR
Credential:
Phone: 602-279-2400