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General NPI Number Information
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NPI Number | 1184129579
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Entity Type | Organization
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Legal Business Name | MOBILEMD, LLC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 6841 W ESCUDA RD
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City | GLENDALE
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State | AZ
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Zip | 85308-5584
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Country | US
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Telephone | 602-529-9700
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Fax | 602-321-6686
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Provider Business Mailing Address
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Address Line | PO BOX 10271
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City | GLENDALE
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State | AZ
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Zip | 85318-0271
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RICHARD NAVARRO
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Credential |
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Telephone | 602-703-1619
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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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