Healthcare Provider Details

I. General information

NPI: 1497964449
Provider Name (Legal Business Name): ARIZONA PEDIATRIC CLINICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 E WASHINGTON ST SUITE 106
PHOENIX AZ
85034-1052
US

IV. Provider business mailing address

809 E WASHINGTON ST SUITE 106
PHOENIX AZ
85034-1052
US

V. Phone/Fax

Practice location:
  • Phone: 602-340-1429
  • Fax:
Mailing address:
  • Phone: 602-340-1429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number16323
License Number StateAZ

VIII. Authorized Official

Name: DR. EDWARD ENRIQUE QUIROZ
Title or Position: PRESIDENT AND OWNER
Credential: MD
Phone: 602-340-1429