Healthcare Provider Details

I. General information

NPI: 1568273738
Provider Name (Legal Business Name): PLEASANT PEDIATRICS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41930 N VENTURE DR STE 160
PHOENIX AZ
85086-3860
US

IV. Provider business mailing address

10180 W HAPPY VALLEY PKWY STE 100
PEORIA AZ
85383-1389
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-3380
  • Fax: 623-322-4399
Mailing address:
  • Phone: 623-322-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PRASAD RAVI
Title or Position: PRACTICE MANAGER
Credential:
Phone: 623-322-3380