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Organization
MOBILE MEDICAL LLC
Active
Organization
MOBILE MEDICAL LLC
Active
Other names
MOBILE MEDICAL LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TABITHA ROSE TAYLOR (OWNER)
(602) 881-5430
Entity
Organization
Contact information
Practice address
4120 N 108TH AVE STE 116, PHOENIX, AZ 85037-5773
(602) 881-5430
(623) 399-9958
Mailing address
8109 W DREYFUS DR, PEORIA, AZ 85381-4954
(602) 881-5430
(623) 399-9958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33819
MED DIRECTORS AZ LIC NUMBER
AZ
Enumeration date
01/24/2019
Last updated
06/11/2019
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