| Mobile Care Physicians Group Pc | |
|
755 N Brown Rd Ste 200 Lawrenceville GA 30043 | |
| (206) 738-4179 | |
| Not Available |
| Full Name | Mobile Care Physicians Group Pc |
|---|---|
| Speciality | Social Worker |
| Location | 755 N Brown Rd, Lawrenceville, Georgia |
| Authorized Official Name and Position | Leonid Popov (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5104175142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Care Physicians Group Pc 8270 Woodland Center Blvd Tampa FL 33614-2401 Ph: (630) 454-0257 | Mobile Care Physicians Group Pc 755 N Brown Rd Ste 200 Lawrenceville GA 30043 Ph: (206) 738-4179 |
| NPI Number | 1457010126 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/28/2023 |
| Certification Date | 12/28/2023 |
| Medicare PECOS PAC ID | 8426440892 |
|---|---|
| Medicare Enrollment ID | O20220627000179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457010126 | NPI | - | NPPES |
| 2240771 | Medicaid | WA |
| Provider Name | Sarah Christine Davison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235552308 PECOS PAC ID: 2365876190 Enrollment ID: I20200102001002 |
| Provider Name | Ann F Lauritsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568614873 PECOS PAC ID: 0143254995 Enrollment ID: I20210217003073 |
| Provider Name | Rebecca Jo Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861529976 PECOS PAC ID: 5193115368 Enrollment ID: I20211201002739 |
| Provider Name | Heidi Chiyomi Yamamoto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265106942 PECOS PAC ID: 4183010374 Enrollment ID: I20220418000360 |
| Provider Name | Sajad Zalzala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639311509 PECOS PAC ID: 5092962209 Enrollment ID: I20220707002217 |
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