# HAVASU RAINBOW PEDIATRICS AND ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528973534
- **Authorized official:** MARY RENEE GOLDEN DNP (MEMBER MANAGER)
- **Authorized official phone:** (317) 414-5202

## Contact information

- **Practice address:** 150 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5735
- **Practice address phone:** (928) 540-5437
- **Practice address fax:** (928) 540-5438
- **Mailing address:** 150 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5735
- **Mailing address phone:** (928) 540-5437
- **Mailing address fax:** (928) 540-5438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2026
- **Last updated:** 08/14/2026