# WESTERN MOBILE MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Western Mobile Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093217713
- **Authorized official:** DEBRA LASETER NP (CEO)
- **Authorized official phone:** (480) 246-3275

## Contact information

- **Practice address:** 18441 N 25TH AVE STE 103, PHOENIX, AZ 85023-1256
- **Practice address phone:** (480) 246-3275
- **Practice address fax:** (480) 246-3274
- **Mailing address:** 18441 N 25TH AVE STE 103, PHOENIX, AZ 85023-1256
- **Mailing address phone:** (480) 246-3275
- **Mailing address fax:** (480) 246-3274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2018
- **Last updated:** 04/09/2018