Bellair Medical Clinic, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

6919 Issued in AZ

Legal business name

BELLAIR MEDICAL CLINIC, P.C.

Practice address

17250 N 43Rd Ave
Suite 4
Glendale, AZ 85308-4035

Phone

(602) 978-4157

Fax

(602) 938-8064

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Amor C. Villareal, M.D.

Title

Trustee

Phone

(602) 978-4157

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104946771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17250 N 43RD AVE",
            "address_2": "SUITE 4",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084035",
            "telephone_number": "602-978-4157",
            "fax_number": "602-938-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17250 N 43RD AVE",
            "address_2": "SUITE 4",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084035",
            "telephone_number": "602-978-4157",
            "fax_number": "602-938-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAIR MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILLAREAL",
        "authorized_official_first_name": "AMOR",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "602-978-4157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "6919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Glendale, AZ
• Providers in Glendale, 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 22, 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.