Provider Demographics
NPI:1851318604
Name:HEALING HEARTS PEDIATRICS
Entity Type:Organization
Organization Name:HEALING HEARTS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-821-1400
Mailing Address - Street 1:595 N DOBSON RD STE A18
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4237
Mailing Address - Country:US
Mailing Address - Phone:480-821-1400
Mailing Address - Fax:480-821-2210
Practice Address - Street 1:595 N DOBSON RD STE A18
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4237
Practice Address - Country:US
Practice Address - Phone:480-821-1400
Practice Address - Fax:480-821-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty