Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 47945 | AZ |
N | 207R00000X | Internist | 47945 | AZ |
N | 111NI0900X | Internist | 47945 | AZ |
NPI | 1003128885 |
---|---|
Provider Name | Dr. David Bebawy |
First Address | Chandler, AZ 85286 |
Second Address | Chandler, AZ 85286 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 19/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
826413 | (05) | AZ |