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NPI Code Detail

MEDICARE: PAMELA B. REBAND M.D.

MEDICARE: PAMELA B. REBAND M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician30363AZ

General Provider Information

NPI Number : 1639176233
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA B. REBAND M.D.
Provider Business Mailing Address
First Line : PO BOX 29211
Second Line :
City : PHOENIX
State : AZ
Zip : 85038-9211
Country : US
Telephone Number : 602-273-6770
Fax Number : 602-889-0489
Provider Business Practice Location Address
First Line : 101 CIVIC CENTER LN
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5607
Country : US
Telephone Number : 602-273-6770
Fax Number : 602-889-0489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 12/06/2007

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