Provider Demographics
NPI:1659470300
Name:THRIVE PEDIATRICS
Entity Type:Organization
Organization Name:THRIVE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:MUNSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:909-783-1111
Mailing Address - Street 1:757 W REDLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4641
Mailing Address - Country:US
Mailing Address - Phone:909-783-1111
Mailing Address - Fax:909-796-2122
Practice Address - Street 1:757 W REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4641
Practice Address - Country:US
Practice Address - Phone:909-783-1111
Practice Address - Fax:909-796-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation