Healthcare Provider Details

I. General information

NPI: 1467395905
Provider Name (Legal Business Name): ALEXANDER DAVID REBCHUK MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 THOMAS ROAD
PHOENIX AZ
85013
US

IV. Provider business mailing address

204-2626 ALBERTA STREET
VANCOUVER BC
V5Y 3L4
CA

V. Phone/Fax

Practice location:
  • Phone: 602-406-6759
  • Fax: 602-294-5603
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: