Healthcare Provider Details

I. General information

NPI: 1699112268
Provider Name (Legal Business Name): MICHEL CORBAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 W ORANGE GROVE RD STE 103
TUCSON AZ
85704-2950
US

IV. Provider business mailing address

PO BOX 52156
PHOENIX AZ
85072-2156
US

V. Phone/Fax

Practice location:
  • Phone: 520-838-3540
  • Fax: 520-325-3526
Mailing address:
  • Phone: 520-838-3540
  • Fax: 520-325-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number62941
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number62941
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: