Provider Demographics
NPI:1801816350
Name:EAST VALLEY PEDIATRICS, PLC
Entity Type:Organization
Organization Name:EAST VALLEY PEDIATRICS, PLC
Other - Org Name:FIRST CHOICE OBSTETRICS & GYNECOLOGY, PLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:VONFLUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-615-2070
Mailing Address - Street 1:PO BOX 16455
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85211-6455
Mailing Address - Country:US
Mailing Address - Phone:480-615-2010
Mailing Address - Fax:480-962-0523
Practice Address - Street 1:3921 E BASELINE RD # 120
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2727
Practice Address - Country:US
Practice Address - Phone:480-615-2010
Practice Address - Fax:480-962-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty