Provider Demographics
NPI:1225238827
Name:AVILA, PATRICIA ARMIDA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ARMIDA
Last Name:AVILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 W BELL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3750
Mailing Address - Country:US
Mailing Address - Phone:623-516-4410
Mailing Address - Fax:602-863-5851
Practice Address - Street 1:6206 W BELL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3750
Practice Address - Country:US
Practice Address - Phone:623-516-4410
Practice Address - Fax:602-863-5851
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94981208000000X
AZ37385208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist