Individual provider · Type 1 NPI

San Raban

Physician Assistant · Phoenix, AZ

NPI number 1104693191 Active

Practice location

401 E Bell Rd Ste 18
Phoenix, AZ 85022-2395

Call (480) 677-8282 Map

Fax (888) 316-1686

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed
Surgical Physician Assistant 363AS0400XNone listed
Medical Physician Assistant 363AM0700XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104693191

San Raban's National Provider Identifier is 1104693191, issued on Dec 8, 2023. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 30, 2026.