Healthcare Provider Details

I. General information

NPI: 1366820383
Provider Name (Legal Business Name): SCOTT REBICH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W CHANDLER BLVD
CHANDLER AZ
85224-6141
US

IV. Provider business mailing address

4925 E WELDON AVE
PHOENIX AZ
85018-5543
US

V. Phone/Fax

Practice location:
  • Phone: 888-488-7640
  • Fax: 602-783-1026
Mailing address:
  • Phone: 623-628-2290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number007807
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number007807
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: