Organization
GLENDALE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE SION LOPEZ MD (MEDICAL OFFICER)
(623) 847-5300
Entity
Organization
Contact information
Practice address
6745 N 51ST DR, GLENDALE, AZ 85301-3425
(623) 847-5300
(623) 847-5304
Mailing address
6745 N 51ST DR, GLENDALE, AZ 85301-3425
(623) 847-5300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292340
—
AZ
Enumeration date
09/18/2007
Last updated
11/13/2024
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