Healthcare Provider Details

I. General information

NPI: 1760620959
Provider Name (Legal Business Name): COMMUNITY MOBILE ULTRASOUND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 S EL CAMINO REAL STE A&B
OCEANSIDE CA
92054-9003
US

IV. Provider business mailing address

10948 BIGGE ST
SAN LEANDRO CA
94577-1121
US

V. Phone/Fax

Practice location:
  • Phone: 510-278-9030
  • Fax: 443-842-7264
Mailing address:
  • Phone: 510-278-9030
  • Fax: 510-278-9193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN C CUOMO
Title or Position: AUTHORIZED OFFICIAL/CFO
Credential:
Phone: 800-786-8015