Healthcare Provider Details

I. General information

NPI: 1306467154
Provider Name (Legal Business Name): PEDIATRICS HEALTHCARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7517 S MCCLINTOCK DR STE 103
TEMPE AZ
85283-5011
US

IV. Provider business mailing address

7517 S MCCLINTOCK DR STE 103
TEMPE AZ
85283-5011
US

V. Phone/Fax

Practice location:
  • Phone: 602-610-7337
  • Fax:
Mailing address:
  • Phone: 602-610-7337
  • Fax: 602-962-7072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAHUL BHATIA
Title or Position: OWNER
Credential: MD
Phone: 602-610-7337