DESERT VALLEY PEDIATRICS NPI 1336354984

NPI Information

NPI: 1336354984
Provider Name: DESERT VALLEY PEDIATRICS
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 03D2078893

Address:
4137 N 108TH AVE
PHOENIX, AZ
ZIP 85037
Phone: (623) 877-7337
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DESERT VALLEY PEDIATRICS is a primary care clinic center in Phoenix, AZ. DESERT VALLEY PEDIATRICS NPI is 1336354984. The provider is registered as an organization entity type.

The provider's business location address is:

4137 N 108TH AVE
PHOENIX, AZ
ZIP 85037-459
Phone: (623) 877-7337

The provider's authorized official is Chris O'connell .
The authorized official title is Administrator and has the following contact phone number (623) 877-7337.

The CLIA number assigned to this NPI record is 03D2078893 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 7/5/2011.

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	261QP2300X	Clinic/Center	Primary Care			Yes

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
1	=========	OTHER	ARIZONA	TAX ID

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: 11/14/2023

NPI Synchronization or Removal

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