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General NPI Number Information
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NPI Number | 1386513281
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Entity Type | Organization
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Legal Business Name | PRO CARE MOBILE MD LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1527 19TH ST STE 216
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City | BAKERSFIELD
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State | CA
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Zip | 93301-4455
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Country | US
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Telephone | 818-626-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 1527 19TH ST STE 216
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City | BAKERSFIELD
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State | CA
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Zip | 93301-4455
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Country | US
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Telephone | 818-626-4855
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | JULIUS ANDRE GAYANILO MORAN
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Credential | MBR
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Telephone | 818-912-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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