Healthcare Provider Details

I. General information

NPI: 1346119054
Provider Name (Legal Business Name): ACCESSIBLE MOBILE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2979 MUMFORD CT
RIVERSIDE CA
92503-8807
US

IV. Provider business mailing address

2979 MUMFORD CT
RIVERSIDE CA
92503-8807
US

V. Phone/Fax

Practice location:
  • Phone: 951-433-3863
  • Fax: 951-475-6488
Mailing address:
  • Phone: 951-433-3863
  • Fax: 951-475-6488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARITY EZEAMAMA
Title or Position: PHYSICIAN ASSISTANT
Credential: P.A.
Phone: 909-268-4181