Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 45810 | AZ |
N | 208000000X | Pediatrician | P6613 | TX |
N | 2080P0204X | Pediatric Emergency Doctor | P6613 | TX |
NPI | 1225266034 |
---|---|
Provider Name | Dr. Candace Peyton Engelhardt |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 16/08/2018 |