Basic Information
| Provider Information | |||||||||
| NPI: | 1336109529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RABAN | ||||||||
| FirstName: | GHADA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N HIGLEY ROAD | ||||||||
| Address2: | ATTN: HOSPITALISTS | ||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805432034 | ||||||||
| FaxNumber: | 4805432647 | ||||||||
| Practice Location | |||||||||
| Address1: | 37000 N GANTZEL RD | ||||||||
| Address2: | |||||||||
| City: | SAN TAN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851407303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803944248 | ||||||||
| FaxNumber: | 4803944718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2006 | ||||||||
| LastUpdateDate: | 09/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 32276 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 32276 | AZ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 83011802 | 05 | AZ | MEDICAID | P00085971 | 01 | AZ | RR MEDICARE | OTHER | AZ0745510 | 01 | AZ | BCBS | OTHER |