MEDICARE: MOBILE RAPID RECOVERY 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	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831947647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE RAPID RECOVERY INC

Provider Business Mailing Address
First Line	:	130 W EULALIA ST STE 101
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 W EULALIA ST STE 101
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2806
Country	:	US
Telephone Number	:	747-240-4860
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HAROUTYOUN ASHKHARIAN
Credential	:
Telephone Number	:	818-858-4449

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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