# THE MOBILE MEDICAL OFFICE

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

## Provider details

- **NPI number:** 1639219298
- **Authorized official:** MS. SALLY J. HEWITT M.H.A. (CEO/CFO)
- **Authorized official phone:** (707) 443-4666

## Contact information

- **Practice address:** 1522 THIRD ST., EUREKA, CA 95501-0711
- **Practice address phone:** (707) 443-4666
- **Practice address fax:** (707) 443-6123
- **Mailing address:** P.O. BOX 2020, EUREKA, CA 95502-2020
- **Mailing address phone:** (707) 443-4666
- **Mailing address fax:** (707) 443-6123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | G86644 | CA | Yes |
| 261QC1500X | Community Health Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 09/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | RHM03931G | — | CA |