Provider Demographics
NPI:1508829094
Name:OBENCHAIN, ROBIN L (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:OBENCHAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:4010
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2437
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:2141 E WARNER RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3493
Practice Address - Country:US
Practice Address - Phone:480-255-5886
Practice Address - Fax:480-855-1108
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35188207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00346160OtherRAILROAD MEDICARE
AZ98954OtherAHCCCS
AZP00346160OtherRAILROAD MEDICARE
H74198Medicare UPIN