Healthcare Provider Details

I. General information

NPI: 1477695575
Provider Name (Legal Business Name): STEVEN MICHAEL RACHBACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E LOWELL ST
TUCSON AZ
85721-0095
US

IV. Provider business mailing address

5035 N VIA DE LA GRANJA
TUCSON AZ
85718-7446
US

V. Phone/Fax

Practice location:
  • Phone: 520-621-6496
  • Fax: 520-626-2760
Mailing address:
  • Phone: 520-529-0982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number14806
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: