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General NPI Number Information
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NPI Number | 1457010126
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Entity Type | Organization
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Legal Business Name | MOBILE CARE PHYSICIANS GROUP PC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 755 N BROWN RD STE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043
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Country | US
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Telephone | 206-738-4179
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Fax |
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Provider Business Mailing Address
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Address Line | 8270 WOODLAND CENTER BLVD
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City | TAMPA
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State | FL
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Zip | 33614-2401
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Country | US
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Telephone | 630-454-0257
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | BIMOHIT BAWA
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Credential |
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Telephone | 415-370-6558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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