# DESERT REHAB PROVIDER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942900980
- **Authorized official:** DR. DAVID JUNG MD (OWNER)
- **Authorized official phone:** (989) 798-3087

## Contact information

- **Practice address:** 1675 E VILLA ST, PHOENIX, AZ 85006-4435
- **Practice address phone:** (480) 801-6700
- **Mailing address:** 16772 W BELL RD STE 110-619, SURPRISE, AZ 85374-9702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2023
- **Last updated:** 03/08/2023