# SOURCE MOBILITY INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265147458
- **Authorized official:** MS. ZAARA GATSON PTA (CE0)
- **Authorized official phone:** (562) 259-4119

## Contact information

- **Practice address:** 5150 CANDLEWOOD ST, LAKEWOOD, CA 90712-1925
- **Practice address phone:** (562) 534-1134
- **Mailing address:** 5150 CANDLEWOOD ST, LAKEWOOD, CA 90712-1925
- **Mailing address phone:** (562) 534-1134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251G0304X | Geriatric Physical Therapist | — | NULL | Yes |
| 2251G0304X | Geriatric Physical Therapist | — | — | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 01/23/2023
- **Last updated:** 02/14/2023