David Lar, MD | |
17900 N Porter Rd, Maricopa, AZ 85138-4228 | |
(520) 233-2500 | |
(520) 233-2688 |
Full Name | David Lar |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 17900 N Porter Rd, Maricopa, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962636845 | NPI | - | NPPES |
40836975 | Other | NY | USMLE |
8DK698 | Other | TX | BCBS |
303196501 | Medicaid | TX | |
677857 | Other | CT | AMERICAN BOARD OF PEDIATRICS |
03161066 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 253530-1 (New York) | Secondary |
208000000X | Pediatrics | P4073 (Texas) | Primary |
Entity Name | Banner Childrens Banner Health Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407191216 PECOS PAC ID: 2466697735 Enrollment ID: O20130315000131 |
Mailing Address | Practice Location Address |
---|---|
David Lar, MD 17900 N Porter Rd, Maricopa, AZ 85138-4228 Ph: (520) 233-2500 | David Lar, MD 17900 N Porter Rd, Maricopa, AZ 85138-4228 Ph: (520) 233-2500 |
Elizabeth Ann Allen, CPNP-PC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21300 N John Wayne Pkwy Ste 112, Maricopa, AZ 85139 Phone: 520-568-9500 | |
Dr. Marie Christianne Sandhya Ravi Chandar, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 | |
Dr. Rachel Singer, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 | |
Dr. James Michael Underwood, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 44572 W Bowlin Rd, Maricopa, AZ 85138 Phone: 520-568-2316 Fax: 520-568-2316 | |
Carrie Ann Lipp, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 Fax: 520-233-2531 | |
Dr. Dawn Medler Sorenson, M.D., M.P.H Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 Fax: 520-233-2531 | |
Nurul Itqiyah Hariadi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 Fax: 520-233-2574 |