Organization
SONORAN PEDIATRIC ENDOCRINOLOGY & DIABETES INSTITUTE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA GIBBS BA (PRACTICE MANAGER)
(480) 757-6457
Entity
Organization
Contact information
Practice address
2204 S DOBSON RD, MESA, AZ 85202-6457
(480) 757-6457
(480) 378-7090
Mailing address
2149 E WARNER RD, STE 102, TEMPE, AZ 85284-3494
(480) 610-6159
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
49420
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
961725
—
AZ
Enumeration date
03/24/2017
Last updated
03/17/2018
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