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General NPI Number Information
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NPI Number | 1134580970
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Entity Type | Organization
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Legal Business Name | PLEASANT PEDIATRICS
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 2613 W CAMPBELL AVE
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City | PHOENIX
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State | AZ
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Zip | 85017-3770
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Country | US
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Telephone | 623-322-3380
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Fax | 623-322-4399
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Provider Business Mailing Address
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Address Line | 9059 W LAKE PLEASANT PKWY E540
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City | PEORIA
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State | AZ
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Zip | 85382-8336
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Country | US
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Telephone | 623-322-3380
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Fax | 623-322-4399
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDHYA RAVI
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Credential | MD
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Telephone | 623-322-3380
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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 | 34320
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License Number State | AZ
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