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BETHESDA PEDIATRICS OF QUEEN CREEK NPI 1063727766


NPI Information

NPI: 1063727766
Provider Name: BETHESDA PEDIATRICS OF QUEEN CREEK

Doing Business As: PEDIATRICS OF QUEEN CREEK

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
22709 S ELLSWORTH RD
H101
QUEEN CREEK, AZ
ZIP 85142
Phone: (480) 792-9200
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BETHESDA PEDIATRICS OF QUEEN CREEK is a pediatrics in Queen Creek, AZ. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BETHESDA PEDIATRICS OF QUEEN CREEK NPI is 1063727766. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pediatrics Of Queen Creek.

The provider's business location address is:

22709 S ELLSWORTH RD
H101
QUEEN CREEK, AZ
ZIP 85142-943
Phone: (480) 792-9200
Fax: (480) 792-9206

The provider's authorized official is Emilia Elizabeth Gomez-vieytez .
The authorized official title is Owner and has the following contact phone number (480) 792-9200.

The enumeration date for this NPI number is 8/18/2010 and was last updated on 3/23/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics43623ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1935531MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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