MEDICARE: SUPERIOR MOBILITY, INC.

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
1	332BC3200X	Customized Equipment (DME)
2	332BC3200X	Customized Equipment (DME)	101318	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1972586071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR MOBILITY, INC.

Provider Business Mailing Address
First Line	:	1950 E 220TH ST STE 208
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90810-1651
Country	:	US
Telephone Number	:	310-755-6480
Fax Number	:	310-212-3120

Provider Business Practice Location Address
First Line	:	1901 HOLSER WALK
Second Line	:	SUITE 302
City	:	OXNARD
State	:	CA
Zip	:	93036-2633
Country	:	US
Telephone Number	:	805-640-1332
Fax Number	:	805-604-1334

Authorized Official
Title or Position	:	CEO
Name	:	DOUGLAS ZAER
Credential	:
Telephone Number	:	310-755-6480

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	10/02/2018

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Directions to “SUPERIOR MOBILITY, INC. ” Practice Location

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