=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568611051
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOBILITY EXCELLENCE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2008
-----------------------------------------------------
Last Update Date | 05/07/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3700 NEWPORT BLVD SUITE 200
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92663-3900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-791-8149
-----------------------------------------------------
Fax | 949-612-0204
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3700 NEWPORT BLVD SUITE 200
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92663-3900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-791-8149
-----------------------------------------------------
Fax | 949-612-0204
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOSEPH A. DELSIGNORE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 760-842-7743
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 50161
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------