Healthcare Provider Details

I. General information

NPI: 1821519315
Provider Name (Legal Business Name): DAVID ARTHUR RAYBINE AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 W TOWN AND COUNTRY RD STE G
ORANGE CA
92868-4716
US

IV. Provider business mailing address

PO BOX 52001 DEPT 935
PHOENIX AZ
85072-2001
US

V. Phone/Fax

Practice location:
  • Phone: 714-516-9570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU3204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: