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NPI 1164335444

NPI 1164335444 : GAWIS MOBILE GROUP : VICTORVILLE, CA

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General NPI Number Information
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    NPI Number           |    1164335444
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    Entity Type          |    Organization 
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    Legal Business Name  |    GAWIS MOBILE GROUP 
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Dates
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    Enumeration Date     |    09/25/2026
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    Last Update Date     |    09/25/2026
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Provider Practice Location Address
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    Address Line         |    14443 PARK AVE STE B-2 
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    City                 |    VICTORVILLE
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    State                |    CA
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    Zip                  |    92392-2388
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    Country              |    US
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    Telephone            |    442-316-0313
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10299 TOPAZ AVE 
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    City                 |    HESPERIA
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    State                |    CA
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    Zip                  |    92345-4692
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    Country              |    US
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    Telephone            |    442-316-0313
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     JAKE  CALSI 
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    Credential           |    
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    Telephone            |    442-316-0313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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