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General NPI Number Information
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NPI Number | 1497465470
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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 | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 9305 W THOMAS RD STE 575
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City | PHOENIX
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State | AZ
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Zip | 85037-3372
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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 STE E540
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City | PEORIA
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State | AZ
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Zip | 85382-8396
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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 | PRACTICE MANAGER
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Name | PRASAD RAVI
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Credential |
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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 |
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License Number State |
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