Provider Demographics
NPI:1144923459
Name:INSPIRADA PEDIATRICS LLC
Entity type:Organization
Organization Name:INSPIRADA PEDIATRICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-703-6235
Mailing Address - Street 1:475 E BRUNER AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0237
Mailing Address - Country:US
Mailing Address - Phone:702-763-2263
Mailing Address - Fax:702-723-3765
Practice Address - Street 1:475 E BRUNER AVE
Practice Address - Street 2:STE 130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044
Practice Address - Country:US
Practice Address - Phone:702-763-2263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty