Healthcare Provider Details

I. General information

NPI: 1386898419
Provider Name (Legal Business Name): BRIAN L RABIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 W FAIRVIEW ST STE 1
CHANDLER AZ
85224-4712
US

IV. Provider business mailing address

2201 W FAIRVIEW ST STE 1
CHANDLER AZ
85224-4712
US

V. Phone/Fax

Practice location:
  • Phone: 480-800-4890
  • Fax: 480-427-4766
Mailing address:
  • Phone: 480-800-4890
  • Fax: 480-427-4766

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number50454
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD.200794
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number50454
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: