Healthcare Provider Details

I. General information

NPI: 1053843367
Provider Name (Legal Business Name): DAVID ERIC ORBUCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S DOBSON RD STE 200
CHANDLER AZ
85224-5679
US

IV. Provider business mailing address

725 S DOBSON RD STE 200
CHANDLER AZ
85224-5679
US

V. Phone/Fax

Practice location:
  • Phone: 480-899-7546
  • Fax: 480-899-7599
Mailing address:
  • Phone: 480-899-7546
  • Fax: 480-899-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number79301
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number306468
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: