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General NPI Number Information
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NPI Number | 1528728482
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Entity Type | Organization
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Legal Business Name | SOCAL MOBILE MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 11762 DE PALMA RD STE 1-C304
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City | CORONA
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State | CA
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Zip | 92883-4010
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Country | US
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Telephone | 626-388-8067
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Fax | 877-319-4970
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Provider Business Mailing Address
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Address Line | 11762 DE PALMA RD STE 1-C304
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City | CORONA
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State | CA
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Zip | 92883-4010
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Country | US
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Telephone | 626-388-8067
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Fax | 877-319-4970
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA MARK SADLER
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Credential | CPT1
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Telephone | 626-388-8067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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