Healthcare Provider Details
I. General information
NPI: 1184441917
Provider Name (Legal Business Name): MOBILE-MED WORK HEALTH SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
165 WINGO RD
BYHALIA MS
38611-9804
US
IV. Provider business mailing address
2101 FOREST AVE STE 220A
SAN JOSE CA
95128-1473
US
V. Phone/Fax
- Phone: 877-899-9959
- Fax:
- Phone: 877-899-9959
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0500X |
| Taxonomy | Preventive Medicine/Occupational Environmental Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEAN
FRIEDERS
Title or Position: CHIEF SOLUTIONS OFFICER
Credential:
Phone: 630-292-4023