Healthcare Provider Details

I. General information

NPI: 1679238448
Provider Name (Legal Business Name): MOB JOB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 AIRPORT BLVD STE 203
MOBILE AL
36608-3156
US

IV. Provider business mailing address

5901 AIRPORT BLVD STE 203
MOBILE AL
36608-3156
US

V. Phone/Fax

Practice location:
  • Phone: 251-342-0505
  • Fax: 251-342-0360
Mailing address:
  • Phone: 251-342-0505
  • Fax: 251-342-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN BERNICE KALMBACHER
Title or Position: OWNER
Credential: MD
Phone: 415-847-3864