Organization
DESERT KIDS PEDIATRICS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRAVIOLA R. BROOKS-MARTINEZ MD (OWNER/PHYSICIAN)
(602) 973-9234
Entity
Organization
Contact information
Practice address
6707 N 19TH AVE, STE 109, PHOENIX, AZ 85015-1105
(602) 973-9234
(602) 973-9271
Mailing address
6707 N 19TH AVE, STE 109, PHOENIX, AZ 85015-1105
(602) 973-9234
(602) 973-9271
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28558
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375531
—
AZ
Enumeration date
10/07/2008
Last updated
08/01/2013
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