Provider Demographics
NPI:1801821152
Name:HRABAK, TODD MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:HRABAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13634 N 93RD AVE #100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4248
Mailing Address - Country:US
Mailing Address - Phone:623-933-0301
Mailing Address - Fax:623-933-0224
Practice Address - Street 1:5750 W. THUNDERBIRD RD #G780
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4636
Practice Address - Country:US
Practice Address - Phone:602-314-4220
Practice Address - Fax:602-788-1890
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4812207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ129011OtherMEDICARE PTAN