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General NPI Number Information
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NPI Number | 1326584475
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Entity Type | Organization
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Legal Business Name | MOBAR CARE
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 8107 DE SOTO AVE
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City | CANOGA PARK
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State | CA
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Zip | 91304-4301
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Country | US
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Telephone | 323-387-2755
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Fax |
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Provider Business Mailing Address
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Address Line | 18636 CELTIC ST
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City | NORTHRIDGE
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State | CA
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Zip | 91326-2708
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Country | US
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Telephone | 323-387-2755
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Fax | 818-280-6938
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. MUBEEN NAIMUDDIN
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Credential |
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Telephone | 323-387-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 197609023
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License Number State | CA
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