Healthcare Provider Details

I. General information

NPI: 1124062435
Provider Name (Legal Business Name): TANYA Y PITTS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 W ASPERA BLVD STE 201301
GLENDALE AZ
85308-7947
US

IV. Provider business mailing address

7701 W ASPERA BLVD STE 201301
GLENDALE AZ
85308-7947
US

V. Phone/Fax

Practice location:
  • Phone: 623-465-6060
  • Fax: 623-242-5833
Mailing address:
  • Phone: 623-465-6060
  • Fax: 623-242-5833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number43186
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-30967
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: