Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

San Raban

Individual provider Medical Physician Assistant · NPI 1104693191

San Raban is a Physician Assistant in Gilbert, Arizona. Qualified in 2024, 2 years ago. Practices with Banner Cancer Center Specialists LLC, a 338-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone: (480) 256-6444
Fax: (480) 256-4734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1104693191
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 8, 2023
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Banner Cancer Center Specialists Llc — 338 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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