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General NPI Number Information
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NPI Number | 1376735738
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Entity Type | Organization
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Legal Business Name | BRIGHT HORIZONS PEDIATRICS PC
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 14780 W MOUNTAIN VIEW BLVD STE 201
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City | SURPRISE
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State | AZ
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Zip | 85374-4799
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Country | US
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Telephone | 623-584-5250
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Fax | 623-584-4587
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Provider Business Mailing Address
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Address Line | 9524 W CAMELBACK RD STE. 130-381
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City | GLENDALE
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State | AZ
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Zip | 85305-3104
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Country | US
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Telephone | 623-584-5250
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Fax | 623-584-4587
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MARIO S. BORLONGAN JR.
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Credential | M.D.
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Telephone | 623-584-5250
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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 | 31440
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License Number State | AZ
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