Mobile Medical Llc | |
4120 N 108th Ave Ste 116 Phoenix AZ 85037-5773 | |
(602) 881-5430 | |
(623) 399-9958 |
Full Name | Mobile Medical Llc |
---|---|
Speciality | Family Medicine |
Location | 4120 N 108th Ave Ste 116, Phoenix, Arizona |
Authorized Official Name and Position | Tabitha Rose Taylor (OWNER) |
Authorized Official Contact | 6028815430 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mobile Medical Llc 8109 W Dreyfus Dr Peoria AZ 85381-4954 Ph: (602) 881-5430 | Mobile Medical Llc 4120 N 108th Ave Ste 116 Phoenix AZ 85037-5773 Ph: (602) 881-5430 |
NPI Number | 1912461856 |
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Provider Enumeration Date | 01/24/2019 |
Last Update Date | 06/11/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912461856 | NPI | - | NPPES |
33819 | Other | AZ | MED DIRECTORS AZ LIC NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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