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NPI Code Detail

MEDICARE: MOBILE HEALTH PLLC

MEDICARE: MOBILE HEALTH PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689306573
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE HEALTH PLLC
Provider Business Mailing Address
First Line : 45465 25TH ST E SPC 168
Second Line :
City : LANCASTER
State : CA
Zip : 93535-2392
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10409 PACIFIC PALISADES AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-1221
Country : US
Telephone Number : 661-405-4315
Fax Number :
Authorized Official
Title or Position : FNP-C
Name : DR. JACQUELINE PALMER
Credential :
Telephone Number : 404-447-4007
Provider Enumeration Date : 06/29/2022
Last Update Date : 06/29/2022

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Directions to “MOBILE HEALTH PLLC ” Practice Location

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