MEDICARE: GOOD NIGHT PEDIATRICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146D00000X	Personal Emergency Response Attendant	36344	AZ

General Provider Information

NPI Number	:	1902019300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD NIGHT PEDIATRICS

Provider Business Mailing Address
First Line	:	750 E NORTHERN AVE UNIT 1070
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4174
Country	:	US
Telephone Number	:	202-207-5608
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 E MISSOURI AVE # C200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2458
Country	:	US
Telephone Number	:	602-476-0000
Fax Number	:

Authorized Official
Title or Position	:	PEDIATRICS
Name	:	DR. MOHAMED H. EL-GASIM
Credential	:	M.D. F.A.A.P
Telephone Number	:	602-476-0000

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	05/27/2008

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Directions to “GOOD NIGHT PEDIATRICS ” Practice Location

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