Healthcare Provider Details

I. General information

NPI: 1003128885
Provider Name (Legal Business Name): DAVID BEBAWY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 S ALMA SCHOOL RD
CHANDLER AZ
85286
US

IV. Provider business mailing address

1405 S ALMA SCHOOL RD ATTN: BMG HOSPITALIST TEAM/ AMANDA GUMP
CHANDLER AZ
85286
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-7420
  • Fax: 480-646-3826
Mailing address:
  • Phone: 480-256-7420
  • Fax: 480-646-3826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number47945
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47945
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number47945
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: