| Canyon Pediatrics, Inc | |
|
2451 E Baseline Rd Ste 200 Gilbert AZ 85234-2405 | |
| (480) 776-7155 | |
| Not Available |
| Full Name | Canyon Pediatrics, Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 2451 E Baseline Rd Ste 200, Gilbert, Arizona |
| Authorized Official Name and Position | Richard Brubaker (CEO) |
| Authorized Official Contact | 4805072199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Pediatrics, Inc 2451 E Baseline Rd Ste 130 Gilbert AZ 85234-2487 Ph: (480) 776-7155 | Canyon Pediatrics, Inc 2451 E Baseline Rd Ste 200 Gilbert AZ 85234-2405 Ph: (480) 776-7155 |
| NPI Number | 1053176677 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 03/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053176677 | NPI | - | NPPES |
| 053504 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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