Organization
YUMA CHILDREN'S CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONAL M SUBBU MD (PHYSICIAN)
(928) 819-7000
Entity
Organization
Contact information
Practice address
2150 W 24TH ST, YUMA, AZ 85364-6122
(928) 819-7000
Mailing address
2150 W 24TH ST, YUMA, AZ 85364-6122
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891681
—
AZ
Enumeration date
01/24/2012
Last updated
02/27/2012
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