Healthcare Provider Details

I. General information

NPI: 1720994379
Provider Name (Legal Business Name): REJUVENATE M&B, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E HUNT HWY STE 7
SAN TAN VALLEY AZ
85143-4963
US

IV. Provider business mailing address

270 E HUNT HWY STE 7
SAN TAN VALLEY AZ
85143-4963
US

V. Phone/Fax

Practice location:
  • Phone: 520-487-6156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT WHITE
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 435-890-4440