MEDICARE: GOTMOBILE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2085R0202X	Diagnostic Radiology Physician
2	261QR0208X	Mobile Radiology Clinic/Center
3	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1740854934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOTMOBILE LLC

Provider Business Mailing Address
First Line	:	1218 E ARABIAN LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6735
Country	:	US
Telephone Number	:	949-466-9939
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 E ARABIAN LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6735
Country	:	US
Telephone Number	:	949-466-9939
Fax Number	:	949-281-7707

Authorized Official
Title or Position	:	MEMBER
Name	:	MARTIN CANALES
Credential	:
Telephone Number	:	949-466-9939

Provider Enumeration Date	:	05/13/2021
Last Update Date	:	05/13/2021

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Directions to “GOTMOBILE LLC ” Practice Location

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