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Organization

ESTRELLA INTERNAL MEDICINE AND PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENT M JOHNSON M.D. (PRESIDENT)
(623) 535-5599
Entity
Organization

Contact information

Practice address
14541 W INDIAN SCHOOL ROAD, STE 600, GOODYEAR, AZ 85338-9243
(623) 535-5599
(623) 535-4696
Mailing address
14541 W INDIAN SCHOOL ROAD, STE 600, GOODYEAR, AZ 85338-9243
(623) 535-5599
(623) 535-4696

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
332481
AZ
Enumeration date
05/22/2006
Last updated
11/13/2008
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