MEDICARE: MOBIN MEDICAL CORPORATION

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	261Q00000X	Clinic/Center	A61426	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1659316156	OTHER	CA	INDIVIDUAL NPI NUMBER

General Provider Information

NPI Number	:	1992863013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBIN MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 24816
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-0816
Country	:	US
Telephone Number	:	310-829-5888
Fax Number	:	310-943-2636

Provider Business Practice Location Address
First Line	:	8929 WILSHIRE BLVD
Second Line	:	SUITE 415
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1953
Country	:	US
Telephone Number	:	310-829-5888
Fax Number	:	310-943-2636

Authorized Official
Title or Position	:	MEDICAL BILLER
Name	:	MS. MILBET SIERRA
Credential	:
Telephone Number	:	310-829-5888

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	01/28/2014

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Directions to “MOBIN MEDICAL CORPORATION ” Practice Location

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