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General NPI Number Information
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NPI Number | 1043048523
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Entity Type | Organization
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Legal Business Name | MOBILE PHLEBOTOMIST SERVICES
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 962 OVERTON DR
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City | SAN JACINTO
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State | CA
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Zip | 92582-4250
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Country | US
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Telephone | 951-973-6030
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Fax | 951-654-8600
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Provider Business Mailing Address
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Address Line | 962 OVERTON DR
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City | SAN JACINTO
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State | CA
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Zip | 92582-4250
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Country | US
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Telephone | 951-973-6030
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Fax | 951-654-8600
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Authorized Official
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Title or Position | CEO
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Name | DIANA NEVAREZ
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Credential | PHLEBOTOMIST
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Telephone | 951-973-6030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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