Med-Peds of Yuma, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

45521 Issued in AZ

Legal business name

MED-PEDS OF YUMA, PLLC

Practice address

2435 S Avenue a Ste a
Yuma, AZ 85364-7176

Phone

(928) 366-1026

Fax

(928) 366-1028

NPI assigned

Feb 25, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fahd Al-Alou, M.D.

Title

President

Phone

(928) 366-1026

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tuscany Children Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1063786812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 S AVENUE A STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647176",
            "telephone_number": "928-366-1026",
            "fax_number": "928-366-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 S AVENUE A STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647176",
            "telephone_number": "928-366-1026",
            "fax_number": "928-366-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-PEDS OF YUMA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-25",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "AL-ALOU",
        "authorized_official_first_name": "FAHD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-366-1026",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "45521",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "45521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1679517858",
            "state": "MP"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tuscany Children Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tuscany Children Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathryn Leigh McSwain
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• Gregory S Meador, CRNA
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• Daniela Medina Avila
• Braulia Arleth Alejandrina Medina
• Samantha Ann Medina, LMSW
• Anaid Medrano Navarro

• Pediatrics Physician in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.