Pediatric Health Care

LBN: Pediatric Health Care
Pediatric Health Care is an health care organization with primary practice located at 120 14Th Ave Se Ste A , Puyallup WA 98372-3718. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Pediatric Health Care can be contacted via phone (253) 848-7660, or through Dahan, Mazen via phone (253) 848-7660.

Contact Information

Primary practice address
120 14Th Ave Se Ste A Puyallup WA 98372-3718
Phone: (253) 848-7660
Fax: (253) 841-1801
Website:
Map and Directions
Authorized official contact:
Name: Dahan, Mazen Doctor of Medicine (MD)
Phone: (253) 848-7660

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 025209 MD00038984 Washington

Profile Details

NPI number 1992965750
LBN Legal business name Pediatric Health Care
DBA Doing business as
Authorized official Dahan, Mazen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2008
Last updated Jun 13th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992965750 NPPES
Washington MEDICAID 1115435

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