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General NPI Number Information
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NPI Number | 1063603785
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Entity Type | Organization
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Legal Business Name | HAPPY KIDS PEDIATRICS, P.C.
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 1345 E MAIN ST SUITE 103
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City | MESA
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State | AZ
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Zip | 85203-8947
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Country | US
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Telephone | 480-223-0291
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Fax | 480-223-0295
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Provider Business Mailing Address
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Address Line | 4802 E RAY RD STE 23 PMB 274
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City | PHOENIX
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State | AZ
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Zip | 85044-6410
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Country | US
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Telephone | 480-223-0291
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Fax | 480-223-0295
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. JOSE FRANCISCO CARRAZCO
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Credential | M.D.
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Telephone | 480-223-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 24255
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License Number State | AZ
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