OrganizationActive
Active Kids Pediatrics, PC
NPI 1629325378 · Health Service Clinic/Center · Phoenix, AZ
Provider details
- NPI number
- 1629325378
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Judith Barnes Clark, Pediatrician, Co-Owner(480) 783-8960
- License
- A32674 (AZ)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
15215 S 48th St
Suite 110
Phoenix, AZ 85044-9142
Phone: (480) 783-8960
Fax: (480) 783-8967
Approximate (ZIP-level) locationGet directions
Mailing address
15215 S 48th St
Phoenix, AZ 85044-9142
Registry dates
- Enumerated
- 2012-08-13
- Last updated
- 2012-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.