Provider Demographics
NPI:1003474461
Name:CACTUS PEDIATRIC ORTHOPAEDICS, PLLC
Entity type:Organization
Organization Name:CACTUS PEDIATRIC ORTHOPAEDICS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-551-0300
Mailing Address - Street 1:PO BOX 2767
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-2767
Mailing Address - Country:US
Mailing Address - Phone:480-551-0300
Mailing Address - Fax:
Practice Address - Street 1:3420 S MERCY RD STE 107
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0420
Practice Address - Country:US
Practice Address - Phone:480-551-0300
Practice Address - Fax:480-649-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center