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General NPI Number Information
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NPI Number | 1366034456
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Entity Type | Organization
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Legal Business Name | MOBILE HEALTH PROVIDERS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 317 W LA HABRA BLVD STE 201
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City | LA HABRA
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State | CA
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Zip | 90631-5497
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Country | US
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Telephone | 562-686-2015
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Fax | 562-381-9349
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Provider Business Mailing Address
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Address Line | 317 W LA HABRA BLVD STE 201
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City | LA HABRA
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State | CA
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Zip | 90631-5497
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Country | US
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Telephone | 562-686-2015
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Fax | 562-381-9349
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WYZSCX MERFIL PATACXIL
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Credential | MD
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Telephone | 562-686-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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