Healthcare Provider Details

I. General information

NPI: 1124229653
Provider Name (Legal Business Name): PERSONAL MOBILITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 S.4TH AVE.
INGLEWOOD CA
90305
US

IV. Provider business mailing address

9705 S.4TH AVE.
INGLEWOOD CA
90305
US

V. Phone/Fax

Practice location:
  • Phone: 323-756-0921
  • Fax:
Mailing address:
  • Phone: 323-756-0921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LA SHONDRA R LONG-MUSE
Title or Position: OWNER
Credential:
Phone: 310-988-5332