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General NPI Number Information
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NPI Number | 1013734094
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Entity Type | Organization
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Legal Business Name | LA PAZ DERMATOLOGY PLLC
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 20185 E OCOTILLO RD STE 104
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7663
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Country | US
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Telephone | 602-799-0976
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Fax | 480-864-4399
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Provider Business Mailing Address
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Address Line | 20789 S 209TH ST
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6532
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Country | US
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Telephone | 602-799-0976
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Fax | 480-864-4399
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER GARRICK
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Credential | NP
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Telephone | 602-799-0976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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