MEDICARE: MOBISURG, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	G75045	CA

General Provider Information

NPI Number	:	1265689046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBISURG, INC.

Provider Business Mailing Address
First Line	:	23025 MILL CREEK DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1257
Country	:	US
Telephone Number	:	949-367-0800
Fax Number	:	949-313-7858

Provider Business Practice Location Address
First Line	:	23025 MILL CREEK DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1257
Country	:	US
Telephone Number	:	949-367-0800
Fax Number	:	949-313-7858

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	SHAHRIAR ALIKHANI
Credential	:	MD
Telephone Number	:	949-367-0800

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	03/24/2023

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