Organization Active NPI

Yuma Kids Clinic, PLLC

  • Pediatrics Physician
  • Yuma, AZ
National Provider Identifier
1336471705
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42670 Issued in AZ
Legal business name
YUMA KIDS CLINIC, PLLC
Practice address
2851 S Ave B Ste 2951
Yuma, AZ 85364
Phone
(928) 783-1222
Fax
(928) 783-1444
NPI assigned
Feb 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Authorized official

Name
Saad Al Alou, MDNPI 1689621724
Title
Member
Phone
(928) 783-1222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 42670 AZ Primary

Addresses

Primary practice location

2851 S Ave B Ste 2951
Yuma, AZ 85364

Mailing address

2851 S Ave B Ste 2951
Yuma, AZ 85364
Phone (928) 783-1222

Other identifiers 1

IdentifierTypeStateIssuer
487987MedicaidAZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2003677Yuma Kids Clinic, PLLC2851 S Ave B, Ste 2951, Yuma, AZ 85364Certificate of waiverFeb 16, 2028

National Provider Directory

National Provider Directory

Locations

2851 S Avenue B
Ste 2951
Yuma, AZ 85364
Phone (928) 783-1222

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1336471705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 S AVE B STE 2951",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-783-1222",
            "fax_number": "928-783-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 S AVE B STE 2951",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-783-1222",
            "fax_number": "928-783-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUMA KIDS CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "AL ALOU",
        "authorized_official_first_name": "SAAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "928-783-1222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "42670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487987",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.