PHOENIX CHILDREN'S MEDICAL GROUP NPI 1679703441

NPI Information

  • NPI: 1679703441
  • Provider Name: PHOENIX CHILDREN'S MEDICAL GROUP
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Other Name: PHOENIX CHILDREN'S AMBULATORY SPECIALTY CENTER - NORTHWEST VALLEY
  • Address: 20325 N 51ST AVE
    STE 116
    GLENDALE, AZ
    ZIP 85308
  • Phone: (602) 933-0003

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NPI Details

PHOENIX CHILDREN'S MEDICAL GROUP is a multi-specialty clinic center in Glendale, AZ. PHOENIX CHILDREN'S MEDICAL GROUP NPI is 1679703441. The provider is registered as an organization entity type.
The provider Other Name Is Phoenix Children's Ambulatory Specialty Center - Northwest Valley.

The provider's business location address is:

20325 N 51ST AVE
STE 116
GLENDALE, AZ
ZIP 85308-674
Phone: (602) 933-0003
Fax: (602) 933-6152

The provider's authorized official is Raheel Farough .
The authorized official title is Svp, Managed Care & Payor Strategy and has the following contact phone number (602) 933-3548.

The enumeration date for this NPI number is 7/15/2009 and was last updated on 5/22/2023.

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
1261QM1300XClinic/CenterMulti-SpecialtySH3107ARIZONAYes

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
1876253MEDICAIDARIZONA

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: 3/30/2025

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