Healthcare Provider Details

I. General information

NPI: 1659371219
Provider Name (Legal Business Name): EAST VALLEY CHILDREN'S CTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S GEORGE DR
TEMPE AZ
85282-4172
US

IV. Provider business mailing address

3200 S GEORGE DR
TEMPE AZ
85282-4172
US

V. Phone/Fax

Practice location:
  • Phone: 480-839-9097
  • Fax: 480-839-1762
Mailing address:
  • Phone: 480-839-9097
  • Fax: 480-839-1762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID MICHAEL CURRAN
Title or Position: MANAGING DIRECTOR
Credential: M.D.
Phone: 480-839-9097