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Organization
MOBILE MEDICAL PROVIDERS, INC.
Active
Organization
MOBILE MEDICAL PROVIDERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOULES SALIB MD, MPH (PRESIDENT)
(310) 388-8788
Entity
Organization
Contact information
Practice address
19634 VENTURA BLVD STE 321, TARZANA, CA 91356-2994
(310) 388-8788
(855) 667-6377
Mailing address
19634 VENTURA BLVD STE 321, TARZANA, CA 91356-2994
(310) 388-8788
(855) 667-6377
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A125934
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB229346
MEDICARE PTAN
CA
Enumeration date
10/13/2014
Last updated
12/04/2019
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