| Prime Mobile Physicians Network, Inc | |
|
28212 Kelly Johnson Pkwy Ste 200 Valencia CA 91355-5090 | |
| (213) 228-3538 | |
| (818) 356-4380 |
| Full Name | Prime Mobile Physicians Network, Inc |
|---|---|
| Speciality | General Practice |
| Location | 28212 Kelly Johnson Pkwy Ste 200, Valencia, California |
| Authorized Official Name and Position | Izuchukwu Okpara (PRESIDENT & CEO) |
| Authorized Official Contact | 2132283538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Mobile Physicians Network, Inc 25044 Peachland Ave Ste 209 Newhall CA 91321-5751 Ph: (613) 837-1366 | Prime Mobile Physicians Network, Inc 28212 Kelly Johnson Pkwy Ste 200 Valencia CA 91355-5090 Ph: (213) 228-3538 |
| NPI Number | 1679190664 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 10/29/2020 |
| Certification Date | 10/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679190664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 208600000X | Surgery | () | Secondary |
| 208D00000X | General Practice | () | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | () | Secondary |
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