Pleasant Pediatrics PLC
Organization Active NPI Pediatrics Physician · Youngtown, AZ
NPI 1013323591 · NPPES record last updated Jul 7, 2014
Key facts
- NPI
- 1013323591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 34320 (AZ)
- Legal business name
- PLEASANT PEDIATRICS PLC
- Practice address
- 12030 N 113TH Ave
Youngtown, AZ 85363-1241 - Phone
- (623) 322-3380
- NPI assigned
- Jul 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Sandhya Ravi, MD
- Title
- Owner
- Phone
- (623) 322-3380
Corporate family (same tax ID) 21
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2080545 | Pleasant Pediatrics PLC | Certificate of waiver | Jul 8, 2026 |
National Provider Directory
- Tax ID family
- Pleasant Pediatrics PLC
Locations
12030 N 113th Ave
Youngtown, AZ 85363
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 34320 | AZ | Yes |
Addresses
Primary practice location
12030 N 113TH Ave
Youngtown, AZ 85363-1241
Mailing address
9059 W Lake Pleasant Pkwy Ste E540
Suite E540
Peoria, AZ 85382-8396
Phone (623) 322-3380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 645732 | Medicaid | AZ |
Other names
- Pleasant Pediatrics
Other providers in Youngtown, AZ
- Laura Nichols
- Alexian B Onyenso
- Athena M. Parmenter
- Pediatric Partners, LLC
- Phoenix Senior Living LLC
- Rahul Sharma MD PLLC
- Rajkumar Sugumaran MD PLLC
- Joy A Richardson
- Karina L Robledo
- Raul Sanchez
All providers in Youngtown, AZ · Pediatrics Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.