GLENDALE PEDIATRICS LLC NPI 1043074610

NPI Information

NPI: 1043074610
Provider Name: GLENDALE PEDIATRICS LLC

Doing Business As: GLENDALE PEDIATRICS & FAMILY CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2929 N 75TH AVE STE 5&6
PHOENIX, AZ
ZIP 85033
Phone: (623) 873-1200
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GLENDALE PEDIATRICS LLC is a primary care clinic center in Phoenix, AZ. GLENDALE PEDIATRICS LLC NPI is 1043074610. The provider is registered as an organization entity type.
The provider Is Doing Business As Glendale Pediatrics & Family Care.

The provider's business location address is:

2929 N 75TH AVE STE 5&6
PHOENIX, AZ
ZIP 85033-400
Phone: (623) 873-1200
Fax: (623) 847-5304

The provider's authorized official is Enrique Sion Lopez .
The authorized official title is Physician and has the following contact phone number (623) 847-5300.

The CLIA number assigned to this NPI record is 03D1105938 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2024 and was last updated on 2/13/2024.

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
1	261QH0100X	Clinic/Center	Health Service			No
2	261QP2300X	Clinic/Center	Primary Care			Yes

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

NPI Synchronization or Removal

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