National Provider Identifier Database

CANYON PEDIATRICS INC
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

CANYON PEDIATRICS, INC
815 E UNIVERSITY DR
MESA, AZ85203-8032
Phone: 480-776-7155
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X
Health Maintenance Organization 302R00000X
Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for CANYON PEDIATRICS, INC

NPI Number 1780449348
Legal business name
LBN
CANYON PEDIATRICS, INC
Authorized official RICHARD BRUBAKER - (CEO)
Entity Organization
Organization subpart No
Enumeration date 02/13/2024
Last updated 03/17/2025 - More than a year ago
Sole proprietor1 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

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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