Provider Demographics
NPI:1548392137
Name:RALPH B. RABIN DPM LLC
Entity Type:Organization
Organization Name:RALPH B. RABIN DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RABIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-846-9000
Mailing Address - Street 1:13055 W MCDOWELL RD STE G108
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6450
Mailing Address - Country:US
Mailing Address - Phone:623-846-9000
Mailing Address - Fax:623-846-4021
Practice Address - Street 1:13055 W MCDOWELL RD
Practice Address - Street 2:SUITE G108
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6450
Practice Address - Country:US
Practice Address - Phone:623-846-9000
Practice Address - Fax:623-846-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6092010001Medicare NSC