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General NPI Number Information
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NPI Number | 1538123237
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Entity Type | Organization
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Legal Business Name | PACIFIC MOBILITY CENTER, INC
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 1355 GRAND AVE SUITE 102
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City | SAN MARCOS
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State | CA
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Zip | 92078-2452
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Country | US
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Telephone | 760-471-8884
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Fax | 760-471-4791
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Provider Business Mailing Address
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Address Line | 1355 GRAND AVE SUITE 102
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City | SAN MARCOS
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State | CA
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Zip | 92078-2452
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Country | US
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Telephone | 760-471-8884
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Fax | 760-471-4791
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARY ANN CONNER
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Credential |
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Telephone | 760-471-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 100897
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License Number State | CA
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