| 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 |
|---|---|
| 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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