Organization
SANDLOT PEDIATRICS & YOUNG ADULTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLAS ANTONIO GONZALEZ M.D (PHYSICIAN)
(480) 699-7248
Entity
Organization
Contact information
Practice address
2600 E SOUTHERN AVE, BLDG H, TEMPE, AZ 85282-7610
(480) 699-7248
(480) 664-1961
Mailing address
2600 E SOUTHERN AVE, BLDG- H, TEMPE, AZ 85282
(480) 699-7248
(480) 664-1961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
AZ
208000000X
Pediatrics Physician
Primary
29730
AZ
Other
Enumeration date
03/08/2010
Last updated
09/11/2015
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