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Contact Information

CANYON PEDIATRICS, INC
815 E UNIVERSITY DR
MESA, AZ85203-8032
 Phone: 480-776-7155
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Health Maintenance Organization

302R00000X
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for CANYON PEDIATRICS INC · (Female)

NPI Number 1780449348
Status Active
Credentials
Entity Individual
Enumeration date 02/13/2024
Last updated 03/17/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • AZ Medicaid 053504
  • AZ Other 2048349 AETNA HEALTH CARE
  • AZ Other 6327185 CIGNA US HEALTH CARE
  • AZ Other 1Z5874 HEALTH NET
  • AZ Other 183427266 TRICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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