Healthcare Provider Details
I. General information
NPI: 1679387757
Provider Name (Legal Business Name): MOBILE MED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3420 STANLEY BLVD
PLEASANTON CA
94566-6239
US
IV. Provider business mailing address
3440 STANLEY BLVD
PLEASANTON CA
94566-4904
US
V. Phone/Fax
- Phone: 925-871-8279
- Fax:
- Phone: 925-871-8279
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246QL0900X |
| Taxonomy | Laboratory Management Specialist/Technologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246RP1900X |
| Taxonomy | Phlebotomy Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246R00000X |
| Taxonomy | Pathology Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CHARITY
MANNING
Title or Position: LICENSED PHLEBOTOMIST/ CCMA
Credential:
Phone: 925-871-8279