CANYON PEDIATRICS INC NPI 1053176677

NPI Information

  • NPI: 1053176677
  • Provider Name: CANYON PEDIATRICS, INC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 2451 E BASELINE RD STE 200
    GILBERT, AZ
    ZIP 85234
  • Phone: (480) 776-7155

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NPI Details

CANYON PEDIATRICS, INC is a pediatrics in Gilbert, 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. CANYON PEDIATRICS, INC NPI is 1053176677. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2451 E BASELINE RD STE 200
GILBERT, AZ
ZIP 85234-405
Phone: (480) 776-7155

The provider's authorized official is Richard Brubaker .
The authorized official title is Ceo and has the following contact phone number (480) 507-2199.

The enumeration date for this NPI number is 2/14/2024 and was last updated on 3/17/2025.

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
1208000000XPediatricsYes
2261QP2300XClinic/CenterPrimary CareNo

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
1053504MEDICAIDARIZONA

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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