Surprise Pediatrics

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

28681 Issued in AZ

Legal business name

SURPRISE PEDIATRICS

Practice address

14239 W Bell Rd
Suite 112
Surprise, AZ 85374-2469

Phone

(623) 876-9983

Fax

(623) 876-9984

NPI assigned

Jun 29, 2005

Organization subpart

No

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

Authorized official

Name

Nicholas Minh Pham, MD

Title

Ceo

Phone

(623) 876-9983

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1801893425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "SUITE 112",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-876-9983",
            "fax_number": "623-876-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "SUITE 112",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-876-9983",
            "fax_number": "623-876-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-29",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-876-9983",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "AZ",
            "license": "28681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surprise Memory Care, LP
• Surprise Modern Dentistry LLP
• Surprise Optometric Care
• Surprise Pain and Spine
• Surprise Pediatric Dentistry, PC
• Surprise Residential Assisted Living
• Surprise Smiles of Beauty PC
• Surprise Smiles PLLC
• Surprise Speech Therapy
• Surprise Therapies, LLC

• Legal Medicine in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Legal Medicine in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.