Healthcare Provider Details

I. General information

NPI: 1053247965
Provider Name (Legal Business Name): LILFAM MAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W MAIN AVE STE B
MORGAN HILL CA
95037-4525
US

IV. Provider business mailing address

90 E 3RD ST UNIT 315
MORGAN HILL CA
95037-3549
US

V. Phone/Fax

Practice location:
  • Phone: 408-208-1492
  • Fax:
Mailing address:
  • Phone: 408-208-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MERCEDES LITTLE
Title or Position: FOUNDER/OPERATOR
Credential:
Phone: 408-208-1492