Pediatric Multicare West, LLC

NPI #1689272700 in Lakeside, Arizona

Provider Information

NPI Number: 1689272700
Entity Type: Organization
Organization Name: Pediatric Multicare West, LLC
Primary Specialty: Pediatrics
Enumeration Date: Oct 12, 2020
Last Updated: Oct 12, 2020

Practice Location

Address: 316 W. WHITE MOUNTAIN BLVD.
Address 2: SUITE A
City: Lakeside
State: Arizona
ZIP Code: 85929
Phone: (928) 358-4620

Authorized Official

Name: MRS. REBECCA ANNE RAFFLE
Title: BILLING MANAGER
Phone: (928) 242-1503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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Organizations

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