Healthcare Provider Details

I. General information

NPI: 1841431061
Provider Name (Legal Business Name): ARIZONA PEDIATRICS, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W THOMAS RD
PHOENIX AZ
85013-4213
US

IV. Provider business mailing address

600 W THOMAS RD
PHOENIX AZ
85013-4213
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5731
  • Fax: 602-277-5107
Mailing address:
  • Phone: 602-277-5731
  • Fax: 602-277-5107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARC PEREZ
Title or Position: PRACTICE MANAGER
Credential: CRTT
Phone: 602-277-5731