Healthcare Provider Details

I. General information

NPI: 1801926175
Provider Name (Legal Business Name): ARIZONA INTERNAL MEDICINE & PEDIATRICS CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 365
PHOENIX AZ
85037-3367
US

IV. Provider business mailing address

9305 W THOMAS RD STE 365
PHOENIX AZ
85037-3367
US

V. Phone/Fax

Practice location:
  • Phone: 602-457-9915
  • Fax: 888-836-5765
Mailing address:
  • Phone: 602-457-9915
  • Fax: 888-836-5765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: ALICIA ACEVEDO-URCUYO
Title or Position: OWNER
Credential: MD
Phone: 602-457-9915