Organization
MOBILITY MASTERS NORTHERN CALIFORNIA INC.
Active
Other names
Mobility Masters
Organization subpart
No
Provider details
NPI number
Authorized official
RENATE SUSAN TIPSWORD (CEO)
(707) 525-1994
Entity
Organization
Contact information
Practice address
1575 FARMERS LANE, SANTA ROSA, CA 95405-7525
(707) 525-1994
(707) 525-1920
Mailing address
1575 FARMERS LANE, SANTA ROSA, CA 95405-7525
(707) 525-1994
(707) 525-1920
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
103424
CA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089322152002
BLUE CROSS
CA
05
—
DME03080F
—
CA
Enumeration date
09/20/2006
Last updated
05/29/2014
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