Provider Demographics
NPI:1487072146
Name:RABACH, LAUREN ALYSON (MD)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ALYSON
Last Name:RABACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:
Practice Address - Street 1:7330 N 99TH AVE STE 200A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-3018
Practice Address - Country:US
Practice Address - Phone:602-406-3400
Practice Address - Fax:602-406-0270
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA160182208600000X
NY307111208600000X
AZ76302208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery